Renal Tubular Acidosis

Question 1

What is renal tubular acidosis?

Answer 1

Metabolic acidosis due to pathology in the tubules of the kidney

Question 2

What is renal tubular acidosis due to?

Answer 2

Impaired acid excretion leads to hyperchloremic metabolic acidosis

Question 3

What does renal tubular acidosis lead to?

Answer 3

Activation of the Renin Angiotensin system

Question 4

What does renal tubular acidosis result in?

Answer 4

Potassium wasting and hypokalaemia

Question 5

What is type 1 renal tubular acidosis characterised by?

Answer 5

The distal tubule is unable to excrete hydrogen ions.

Question 6

What are the hereditary causes of type 1 renal tubular acidosis?

Answer 6

Marfan’s
Ehler’s Danlos

Question 7

What are the autoimmune causes of type 1 renal tubular acidosis?

Answer 7

Sjogren’s
SLE
Thyroiditis

Question 8

Where is the pathology with type 1 renal tubular acidosis?

Answer 8

Distal tubule

Question 9

What are possible complications of type 1 renal tubular acidosis?

Answer 9

Nephrocalcinosis
Renal stones
Osteomalacia

Question 10

What are the main features type 1 renal tubular acidosis?

Answer 10

Hypokalaemia
Metabolic acidosis
High urinary pH (above 6)

Question 11

What is the management of type 1 renal tubular acidosis?

Answer 11

Oral bicarbonate.

Question 12

What can nephrocalcinosis lead to?

Answer 12

End stage renal failure

Question 13

How is type 1 renal tubular acidosis diagnosed?

Answer 13

Failure to acidify urine (pH >5.5) despite acid load

Question 14

Where is the pathology in type 2 renal tubular acidosis?

Answer 14

Pathology in the proximal tubule

Question 15

What is type 2 renal tubular acidosis due to?

Answer 15

It is due to a defect in HCO3 reabsorption into the blood from the urine in the proximal tubule

Question 16

How is type 2 renal tubular acidosis diagnosed?

Answer 16

Urine will acidify with an acid load (pH <5.5)

Question 17

What is the main cause of renal tubular acidosis?

Answer 17

Idiopathic associated with Falconi syndrome

Question 18

What does type 2 renal tubular acidosis result in?

Answer 18

Hypokalaemia
Metabolic acidosis
High urinary pH (above 6)

Question 19

What is the management of type 2 renal tubular acidosis?

Answer 19

Oral bicarbonate

Question 20

What is a possible complication of type 2 renal tubular acidosis?

Answer 20

Osteomalacia

Question 21

What is type 3 renal tubular acidosis?

Answer 21

Combination of type 1 and type 2

Question 22

Where is the pathology with type 3 renal tubular acidosis?

Answer 22

In the proximal and distal collecting ducts

Question 23

What is type 4 renal tubular acidosis due to?

Answer 23

Reduced aldosterone.

Question 24

What is the most common type of renal tubular acidosis?

Answer 24

Type 4 renal tubular acidosis

Question 25

What does a reduction in aldosterone lead to?

Answer 25

A reduction in proximal tubular ammonium excretion

Question 26

What are the main causes of type 4 renal tubular acidosis?

Answer 26

Hypoaldosteronism
Diabetes

Question 27

What does type 4 renal tubular acidosis result in?

Answer 27

Hyperkalaemia
High chloride
Metabolic acidosis
Low urinary pH

Question 28

What is the management of type 4 renal tubular acidosis?

Answer 28

Fludrocortisone