Last Updated on Jan 04, 2017

Diagnosis and Treatment

Blood and urine tests help to diagnose renal tubular acidosis. Alkalis form the mainstay of treatment.

Tests used to diagnose renal tubular acidosis (RTA) are:

  • Blood and urine tests to check pH and electrolyte levels - In RTA, the acid level of the blood is higher than normal and that of the urine is lower than normal. Using the electrolyte measurements, a parameter called the anion gap is determined. Patients with RTA have a normal anion gap. This helps to differentiate RTA from other causes of acidosis. Chloride levels are high in all types of RTA. Potassium levels may be low in Type 1 and Type 2 disease but are high in Type 4 diseases.
  • Measurement of urinary pH after giving ammonium chloride, sodium bicarbonate or a loop diuretic (furosemide) is also helpful in arriving at a diagnosis.

Treatment of RTA includes:

  • Use of alkali – Alkalis like sodium bicarbonate or potassium citrate or sodium citrate help to control the acidosis. The use of these drugs often brings all the electrolyte levels to normal. Early treatment also helps to prevent complications.
  • Vitamin D and calcium may be needed in some cases to prevent bone damage.
  • The underlying disease that causes the acidosis should be treated.

Reference

  1. Harrison’s Principles of Internal Medicine 17th edition
  2. Arvind Bagga and Aditi Sinha. Evaluation of Renal Tubular Acidosis. Indian J Pediatr 2007; 74 (7): 679-686

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