Renal Tubular Acidosis Flashcards
What is Renal tubular acidosis?
Metabolic acidosis due to pathology in the tubules of the kidney
Four types each with different pathophysiology
What is Type 1 renal tubular acidosis?
Due to pathology in the DISTAL TUBULE
Unable to excrete hydrogen ions
Causes of Type 1 renal tubular acidosis (7)
Genetic - Both autosomal dominant and recessive forms
Systemic lupus erythematosus
Sjogren’s syndrome
Primary biliary cirrhosis
Hyperthyroidism
Sickle cell anaemia
Marfan’s syndrome
How does Type 1 renal tubular acidosis present? (4)
Failure to thrive in children
Hyperventilation to compensate for the metabolic acidosis
Chronic kidney disease
Bone disease (osteomalacia)
What is seen on blood results in Type 1 and Type 2 renal tubular acidosis? (3)
Hypokalaemia
Metabolic acidosis
High urinary pH (above 6)
What is the treatment for Type 1 and Type 2 renal tubular acidosis?
Bicarbonate
What is Type 2 renal tubular acidosis?
Due to pathology in the PROXIMAL TUBULE
Unable to reabsorb bicarbonate
What is the main cause of Type 2 renal tubular acidosis?
Fanconi’s syndrome
What is Type 3 renal tubular acidosis?
Combination of tpye 1 and type 2
What is Type 4 renal tubular acidosis?
Most common cause of renal tubular acidosis
Caused by reduced aldosterone
What casues Type 4 renal tubular acidosis?
Adrenal insufficiency
Medications such as ACE inhibitors and spironolactone
Systemic conditions that affect the kidneys such as systemic lupus erythematosus, diabetes or HIV
What is seen on blood results in Type 4 renal tubular acidosis? (4)
Hyperkalaemia
High chloride
Metabolic acidosis
Low urinary pH
How is Type 4 renal tubular acidosis treated?
Fludrocortisone
Sodium bicarbonate and treatment of the hyperkalaemia may also be required
