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Renal Tubular Acidosis

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Renal Tubular Acidosis

  • Pathophysiology
  1. Kidney unable to excrete daily acid load
  2. Results in Metabolic Acidosis
  • Types
  1. Type I Renal Tubular Acidosis: Distal RTA (Classic RTA)
  2. Type II Renal Tubular Acidosis: Proximal RTA
  3. Type IV Renal Tubular Acidosis: Hyperkalemic RTA
  • Labs
  1. Chemistry Panel
    1. Serum Chloride elevated
    2. Serum bicarbonate decreased
    3. Anion Gap normal
  2. Arterial Blood Gas (ABG)
    1. Non-Anion Gap Metabolic Acidosis
  3. Fractional Excretion of Bicarbonate
    1. FE-HCO3 <5%: Distal RTA
    2. FE-HCO3 >15%: Proximal RTA
      1. Assumes serum bicarbonate >20 meq/L