distal renal tubular acidosis

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distal renal tubular acidosis (RTA)

an abnormal condition characterized by excessive acid accumulation and bicarbonate excretion. It is caused by the inability of the kidney's distal tubules to secrete hydrogen ions, thus decreasing the excretion of titratable acids and ammonium and increasing the urinary loss of potassium and bicarbonate. The condition may cause hypercalciuria and the formation of kidney stones. Treatment is the same as for renal tubular acidosis. Primary distal RTA occurs mostly in females, adolescents, older children, and young adults. It may occur sporadically or result from hereditary defects. Secondary distal RTA is associated with numerous disorders, such as cirrhosis of the liver, malnutrition, starvation, and various genetic abnormalities. Compare proximal renal tubular acidosis.
References in periodicals archive ?
Distal RTA (dRTA) leading to recurrent hypokalemia and paresis as an initial manifestation of primary Sjogren's syndrome (pSS) is well-known but not commonly reported (1), as pSS is one of the secondary causes of dRTA.
Based on the above clinical presentation and the attendant laboratory work, a diagnosis of distal RTA (dRTA) due to primary Sjogren's syndrome was made.
2) RTA is suspected in the presence of hyperchloremic metabolic acidosis (HMA) and it is divided into three categories: proximal RTA, distal RTA (dRTA), and hyperkalemic RTA.
Distal RTA occurs in up to 5% of patients with pSS; however, the prevalence of symptomatic dRTA was not assessed in this study.
Typical findings of type 1 distal RTA (dRTA) include low serum bicarbonate, normal serum anion gap, hyperchloremia and hypokalemia.
We were unable to determine the etiology of RTA in our case, however, owing to the association of distal RTA with autoimmune diseases, a possible autoimmune etiology must always be sought.
1) A frank distal RTA was found in 5% of patients with Sjogren's syndrome.
3) Distal RTA is a clinical syndrome consisting of hypokalemia, hyperchloremic metabolic acidosis, inability to lower urine pH below 5 during acidemia, nephrocalcinosis and nephrolithiasis.
Of the different types of RTA associated with hypokalemia, distal RTA may be due to a defect in proximal tubular reabsorption found in the bicarbonate ion (HC[O.
DISCUSSION: In view of history and investigations, possibility of renal tubular dysfunction secondary to distal RTA was considered.

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