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Distal renal tubular acidosis

Renal tubular acidosis - distal; Renal tubular acidosis type I; Type I RTA; RTA - distal; Classical RTA

Distal renal tubular acidosis is a disease that occurs when the kidneys do not properly remove acids from the blood into the urine. As a result, too much acid remains in the blood (called acidosis).

Images

Kidney anatomy
Kidney - blood and urine flow

Causes

When the body performs its normal functions, it produces acid. If this acid is not removed or neutralized, the blood becomes too acidic. This can lead to electrolyte imbalances in the blood. It can also cause problems with normal function of some cells.

The kidneys help control the body's acid level by removing acid from the blood and excreting it into the urine.

Distal renal tubular acidosis (type I RTA) is caused by a defect in the kidney tubes that causes acid to build up in the blood.

Type I RTA is caused by a variety of conditions, including:

Symptoms

Symptoms of distal renal tubular acidosis include any of the following:

Other symptoms may include:

Exams and Tests

The health care provider will perform a physical exam and ask about your symptoms.

Tests that may be ordered include:

Calcium deposits in the kidneys and kidney stones may be seen on:

Treatment

The goal is to restore normal acid level and electrolyte balance in the body. This will help correct bone disorders and reduce calcium buildup in the kidneys (nephrocalcinosis) and kidney stones.

The underlying cause of distal renal tubular acidosis should be corrected if it can be identified.

Medicines that may be prescribed include potassium citrate, sodium bicarbonate, and thiazide diuretics. These are alkaline medicines that help correct the acidic condition of the body. Sodium bicarbonate may correct the loss of potassium and calcium.

Outlook (Prognosis)

The disorder must be treated to reduce its effects and complications, which can be permanent or life threatening. Most cases get better with treatment.

When to Contact a Medical Professional

Contact your provider if you have symptoms of distal renal tubular acidosis.

Get medical help right away if you develop emergency symptoms such as:

Prevention

There is no prevention for this disorder.

Related Information

Respiratory alkalosis
Metabolic acidosis
Calcium blood test
Osteomalacia
Rickets
Weakness
Kidney stones
Nephrocalcinosis
Low blood potassium

References

Bushinsky DA. Kidney stones. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 32.

Dixon BP. Renal tubular acidosis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 547.

Seifter JL. Acid-base disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 110.

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Review Date: 10/31/2021  

Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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