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Renal Tubular Acidosis, Pediatric

Elaine Ku, MD, MAS Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Renal tubular acidosis (RTA) is characterized by hyperchloremic metabolic acidosis in the setting of normal or near-normal glomerular filtration rate (GFR).

  • The acidification defect c...

DIAGNOSIS

HISTORY

  • Failure to thrive in infants and children

  • Polyuria

  • Constipation

  • Anorexia

  • Symptoms of hypokalemia:

    • Muscle weakness

    • Constipation

  • Kidney stones

  • Intellectual disability

  • Propensity for fractures

PHYSICAL EXAM

TREATMENT

GENERAL MEASURES

  • Vitamin D supplementation as needed

  • Phosphorus supplementation as needed (if concurrent Fanconi syndrome)

MEDICATION

  • Alkali supplementation given as sodium or potassium bicarbon...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Frequent monitoring of serum electrolytes

  • Close follow-up of linear growth

  • Renal ultrasound to monitor for evidence or progression of nephrocalcinosis

PROGNOSIS

  • Can r...

ADDITIONAL READING

  • Batlle D, Haque SK. Genetic causes and mechanisms of distal renal tubular acidosis. Nephrol Dial Transplant.  2012;27(10):3691–3704. [View Abstract on OvidInsights]

  • Haque SK, Ar...

CODES

ICD9

588.89 Other specified disorders resulting from impaired renal function 

ICD10

N25.89 Other disorders resulting from impaired renal tubular function 

SNOMED

  • 1776003 Renal tubular acidosis (disor...

FAQ

  • Q: Can RTA be diagnosed in the setting of renal failure?

  • A: No. Typically, RTA is diagnosed in the setting of relatively preserved renal function. Renal function associated with non–anion or anion ...

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