Diagnosaurus
Renal tubular acidosis
Etiology
- Type I (distal H+ secretion defect): low serum K+, urine pH >5.5, associated with autoimmune disease, hypercalcemia
- Type II (proximal HCO3- reabosrbtion defect): low serum K+, urine pH < 5.5, associated with multiple myeloma, drugs (eg, sulfa)
- Type III (rare): normal serum K+, urine pH < 5.5, associated with renal insufficiency
- Type IV (hyporeninemic hypoaldosteronism): high serum K+, urine pH < 5.5, associated with diabetes mellitus, drugs (eg, NSAIDs)
DDx
Other causes of normal gap metabolic acidosis
- Gastrointestinal loss of HCO3-, eg, diarrhea, pancreatic ileostomy or ileal loop bladder
- Renal tubular acidosis
- Recovery from diabetic ketoacidosis
- Dilutional acidosis from rapid administration of 0.9% NaCl
- Carbonic anhydrase inhibitors
- Chloride retention or administration of HCl equivalent or NH4Cl
See related DDx
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Citation
Zeiger, Roni F.. "Renal Tubular Acidosis." Diagnosaurus, 4th ed., McGraw-Hill Education, 2015. 5minute, www.unboundmedicine.com/5minute/view/Diagnosaurus/114288/all/Renal_tubular_acidosis.
Zeiger RFR. Renal tubular acidosis. Diagnosaurus. McGraw-Hill Education; 2015. https://www.unboundmedicine.com/5minute/view/Diagnosaurus/114288/all/Renal_tubular_acidosis. Accessed February 27, 2021.
Zeiger, R. F. (2015). Renal tubular acidosis. In Diagnosaurus (4th edition). McGraw-Hill Education. https://www.unboundmedicine.com/5minute/view/Diagnosaurus/114288/all/Renal_tubular_acidosis
Zeiger RFR. Renal Tubular Acidosis [Internet]. In: Diagnosaurus. McGraw-Hill Education; 2015. [cited 2021 February 27]. Available from: https://www.unboundmedicine.com/5minute/view/Diagnosaurus/114288/all/Renal_tubular_acidosis.
* Article titles in AMA citation format should be in sentence-case
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T1 - Renal tubular acidosis
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A1 - Zeiger,Roni F,
BT - Diagnosaurus
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