Renal Tubular Acidosis

Lewjain Sakr, MD Reviewed 05/2023

BASICS

Renal tubular acidosis (RTA) is a group of disorders characterized by an inability of the kidney to resorb bicarbonate (HCO₃)/secrete hydrogen ions, resulting in normal anion gap met...

Often asymptomatic (particularly type IV). In children: failure to thrive, rickets
Anorexia, nausea/vomiting, constipation. Weakness or polyuria (due to hypokalemia or hypercalciuria)
P...

Provide oral alkali to raise serum HCO₃ to normal. Start at a low dose and increase until HCO₃ is normal. Give as sodium bicarbonate (HCO₃) (7.7 mEq NaHCO₃/650 mg tab), s...

Electrolytes 1 to 2 weeks following initiation of therapy, monthly until serum HCO₃ corrected to desired range, and then as clinically indicated...

Mohebbi N, Wagner CA. Pathophysiology, diagnosis and treatment of inherited distal renal tubular acidosis. J Nephrol. 2018;31(4):511-522.

Yaxley J, Pirrone C. Review of the Diagnostic Eval...

N25.89 Oth disorders resulting from impaired renal tubular function

Consider RTA in cases of normal anion gap metabolic acidosis with normal renal function.
Type I RTA: urine pH >5.5 in setting of acidemia; positive UAG; acidemia can be severe.
Type I...

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