Renal tubular acidosis classification
|
Renal tubular acidosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Renal tubular acidosis classification On the Web |
|
American Roentgen Ray Society Images of Renal tubular acidosis classification |
|
Risk calculators and risk factors for Renal tubular acidosis classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2] Syed Ahsan Hussain, M.D.[3] Jogeet Singh Sekhon, M.D. [4]
Overview
Based on underlying defect in concentration of urine process in renal tubule, renal tubular acidosis can be classified into type 1 (distal), type 2 (proximal), type 4 (hypoaldosteronism) and voltage-dependent RTA.
Classification
Renal tubular acidosis can be classified into 4 types. Renal tubular acidosis type 1( distal), renal tubular acidosis type 2 ( proximal), hypoaldosteronism (type 4) and voltage-dependent RTA. Potassium is the most common electrolyte abnormality associated renal tubular acidosis. Hypokalemia is seen in RTA type 1 and type 2 while type 4 and voltage-dependent RTA are hyperkalemic.[1][2][3]
| Type of RTA | Primary defect | Plasma HCO3 mEq/L | Urine pH | Plasma potassium | Urine anion gap | Urine calcium/creatinine ratio | Risk for nephrolithiasis |
|---|---|---|---|---|---|---|---|
| RTA type 1 | Impaired distal acidification | < 10 | >5.3 | Hypokalemic | Positive | ↑ | ↑ |
| RTA type 2 | Reduced proximal HCO3 reabsorption. | 12 to 20 | <5.3 | Hypokalemic | Negative | Normal | - |
| RTA type 3 | Mixed (distal+ proximal RTA) | Variable | Variable | Variable | Variable | Variable | Variable |
| RTA type 4 | Decreased aldosterone secretion
Aldosterone resistance |
>17 | Variable | Hyperkalemia | Positive | Normal | - |
| Voltage-dependent RTA | Reduced sodium reabsorption | >17 | Variable | Hyperkalemia | Positive | Normal | - |
References
- ↑ Gil-Peña H, Mejía N, Santos F (April 2014). "Renal tubular acidosis". J. Pediatr. 164 (4): 691–698.e1. doi:10.1016/j.jpeds.2013.10.085. PMID 24345454.
- ↑ Rodriguez-Soriano J, Edelmann CM (1969). "Renal tubular acidosis". Annu. Rev. Med. 20: 363–82. doi:10.1146/annurev.me.20.020169.002051. PMID 4894504.
- ↑ Morris RC (December 1969). "Renal tubular acidosis. Mechanisms, classification and implications". N. Engl. J. Med. 281 (25): 1405–13. doi:10.1056/NEJM196912182812508.