Question

What Should You Know About Renal Tubular Acidosis?

Dr.Sonia Sharma · Accepted Answer

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.

Renal Tubular Acidosis is simply associated with abnormal urinary acidification. Other functions of the kidneys remain unimpaired.
There are several different types of renal tubular acidosis-

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.

Taeniasis Health Feed

What Should You Know About Renal Tubular Acidosis?

I want to reduce my triglycerides count from 190 to 120 in about 3-4 days. I am vegan. Please suggest a diet.

My triglyceride level was 486 in February my doctor prescribed me lipicard 200 mg and tonact plus but now my level is 103, still doc advised to take both medicine do I really need medicine lipicard 200 mg and tonact plus now when triglyceride is 103.

How Cracks Are Different From Fractures?

My S.triglycerides level high 236. 0 mg wht I do to control it what I eat and what I not eat.

I am 32 years old. My triglycerides level 288 Dr. Give me rosukem f10 tablets. It's good tablets? Any side effects. How much take this medicine.

I have fatty liver and my triglyceride is 399 Dr. prescribe me rosuvas f 20 tab. Can I take it?

Physiotherapy Treatment For Cervical Osteoarthritis!

My sr Triglycerides level is 256. Also VLDL is 50. Kindly suggest weather I need to go for treatment or exercises. BP is 130/85. Non diabetic. HR 5'10 weight 90 kg Age 34 Sex Male.

My triglycerides is 198 and sugar level is also high. Doct has prescribed Rosys FT 10 for lowering triglycerides shall I take these tablets or it can be controlled with diet?