What is Acidosis and it's Type :
First type of acidosis is respiratory acidosis when there is more carbon-dioxide in the blood. Lungs do not eliminate the carbon dioxide in the body this leads to build-up of carbon dioxide in the blood. Some factors lead to excess carbon dioxide in the blood namely – asthma, chest injury, obesity, sedative abuse, deformed chest, nervous system problem to name a few. When there is excessive lactic acid in the blood it is called lactic acidosis.
Second type of acidosis is caused due to the kidneys. Kidneys need to maintain the PH balance in the blood and when this function is improper it results in metabolic acidosis. Kidneys do not excrete the excess acid in the blood or eliminate more sodium bicarbonate. Poorly controlled diabetes, loss of sodium bicarbonate, too much lactic acid build up in the body due to cancer, liver failure, alcohol consumption are some factors that cause acidosis.
Risk Factors :
People experience shortness of breath, fatigue, confusion, sleeplessness and headache when they have acidosis. In metabolic acidosis the person suffers from shallow breathing, confusion, headache, and fruity breath smell.
Treatment of acidosis is important to avoid further complications. Higher the PH of blood by administering sodium bicarbonate through medicines or intravenously is the first method of treatment. This brings in normal PH balance in the blood.
Normally patients recover from acidosis to lead a normal life. They need to be extra careful if they have diabetes or asthma and prevent occurrence of acidosis. People who have healthy lungs and kidneys suffer from mild acidosis which can be easily cured.
Renal Tubular Acidosis is a medical condition. When the kidney is unable to acidify urine, it leads to the accumulation of acid in the body. Usually, when blood is filtered by the kidney, it passes through the tubules of the nephrons (the functional unit of the kidney).
Before it flows into the bladder from the kidney, the urine undergoes an exchange of salts, acids and other solutes. Renal tubular acidosis results in the formation of excessive amounts of acid because the kidneys cannot drain them. This may happen because the kidneys cannot reabsorb the alkaline bicarbonate ions from the urine in the early segment of the nephron or because of inadequate production of acidic hydrogen ions in the latter half of the nephron.
• Distal Renal Tubular Acidosis (RTA)
This is the most fundamental form of RTA. It is characterized when the hydrogen ions are not secreted into the lumen of the nephron by the alpha-intercalated cells of the medullary collective duct of the distal nephron. When this happens the pH of urine cannot be brought down below 5.3. Renal excretion is inhibited and hydrogen ions are not eliminated which leads to academia. At the same time, Potassium ions cannot be absorbed by the cell which leads to hypokalemia. The end result is protein retention and potassium excretion. Distal RTA can lead to the urinary stone formation, calcium deposits in the kidney, rickets and osteomalacia and Sjogren’s syndrome.
• Proximal RTA
When proximal tubular cells reabsorb 85% of filtered bicarbonates and 60% of filtered sodium from the urine, then this again leads to academia. The distal intercalated cells, however, function normally and so the academia is not as severe as in case of Distal RTA. The alpha-intercalated cells can acidify urine to a pH of 5.3 or less because they produce hydrogen ions. Proximal RTA is also associated with Fanconi Syndrome which is characterized by aminoaciduria, uricosuria, glucosuria, and tubular proteinuria.
• Combined distal and proximal RTA
Inherited carbonic anhydrase II deficit leads to combined distal and proximal RTA. This is accompanied by osteopetrosis, cerebral calcification, and renal tubular acidosis. Cases of combined distal and proximal RTA are very rare.
How is RTA understood?
The following steps are applied to analyze Renal Tubular Acidosis-
• Determining the anion gap in acidosis. The normal Anion Gap is 8-12 (4-6 mEq/L)
• Separating the renal from the extrarenal causes of normal anion gap acidosis
• Classifying the types of RTA
• If it is distal RTA, further tests will be necessary to support the diagnosis
How is RTA diagnosed?
Three types of tests can reveal if a person is affected by Renal Tubular Acidosis-
• Urine test
• Acid load test
• Physical examination
Treatment of RTA-
Doctors prescribe either or both of the following two types of therapies-
• Alkali therapy- The pH level of urine is restored and electrolytes are balanced
• Vitamin D supplements- If RTA leads to bone deformities or rickets, your doctor will prescribe vitamin supplements to strengthen your bones.
Timely diagnosis can prevent the effects of Renal tubular Acidosis from becoming compounded. With the right medication, a person can lead a healthy normal life.
What is Acidosis and it's Type :
Risk Factors :