Renal Tubular Acidosis (RTA)
Proximal RTA (Type 2 RTA): · Generalized Proximal Tubular dysfunction. · Manifested by glycosuria, generalized aminoaciduria, and phosphaturia (Fanconi syndrome). · Therapy with NaHCO 3 causes hypokalemia. · Drug induced: Acetazolamide, topiramate Treatment: · Sodium and Potassium citrate syrup (citric acid 334mg, sodium citrate 500mg, potassium citrate 550mg per 5ml) · Syrup preparation is not recommended for chronic administration. Classic Distal RTA (Type 1 RTA): · Hypokalemia, a non-AG metabolic acidosis, low urinary NH 4 + excretion, inappropriately high urine pH (pH > 5.5). · Hypocitraturia, hypercalciuria, so nephrolithiasis, neprocalcinosis and bone disease are common. · Drug induced: Amphotericin B, ifofamide Treatment: · Acutely acidotic patient with Hypokalemia: administer potassium. · Chronic therapy: Sodium citrate (Shohl’s solution) O