Renal tubular acidosis

Question 1

What is renal tubular acidosis?

Answer 1

Where there is a metabolic acidosis due to pathology in the renal tubules

Question 2

Name the different types of renal tubular acidosis. Which types are the most common?

Answer 2

Type 1, 2, 3 and 4 (1 and 4 are the most common)

Question 3

Describe the pathophysiology of type 1 renal tubular acidosis

Answer 3

Type 1 renal tubular acidosis is caused by pathology in the distal tubule - unable to excrete hydrogen ions

Question 4

Give a few examples of causes of type 1 renal tubular acidosis

Answer 4

• Genetic

- Autoimmune conditions, e.g. SLE, Sjogrens syndrome

Question 5

Describe the management of type 2 renal tubular acidosis

Answer 5

Bicarbonate

Question 6

Describe the pathophysiology of type 4 renal tubular acidosis

Answer 6

Type 4 renal tubular acidosis is caused by lack of aldosterone (which causes insufficient excretion of hydrogen and potassium ions in the distal tubule)

Question 7

Give an example of a condition which can cause type 4 renal tubular acidosis

Answer 7

Adrenal insufficiency

Question 8

Describe the management of type 4 renal tubular acidosis

Answer 8

• Fludrocortisone
• Bicarbonate
• Treatment for hyperkalaemia may also be required