renal tubular acidosis Flashcards
what
metabolic acidosis due to pathology in kidney tubules
type 1
due to pathology in distal tubule
it is unable to excrete hydrogen ions
type 1 causes
genetic SLE sjogren's syndrome hyperthyroidism sickle cell anaemia Marfan's
type 1 presentation
FTT
hyperventilation to compensate
CKD
bone disease - osteomalacia
type 1 results in
hypokalaemia
metabolic acidosis
high urinary pH >6
type 1 treatment
oral bicarbonate
type 2
pathology in proximal tubule
is it unable to reabsorb bicarbonate from urine in blood –> excess bicarb is excreted in urine
type 2 main cause
Fanconi’s syndrome
type 2 results in
hypokalaemia
metabolic acidosis
high urinary pH >6
type 2 treatment
oral bicarbonate
type 3
combination of type 1 and 2 resulting in pathology in proximal and distal tubules
type 4
caused by reduced aldosterone
most common cause of renal tubular acidosis
type 4 causes
adrenal insufficiency meds: ACEI, spironolactone SLE diabetes HIV
type 4 results in
hyperkalaemia
high chloride
metabolic acidosis
low urinary pH
type 4 Mx
fludrocortisone
sodium bicarb and rx of hyperkalaemia may also be needed
