Renal Tubular Acidosis - Classical Distal RTA (RTA Type 1)

Classical Distal RTA (RTA Type I)

• In type 1 or Classical Distal Renal Tubular Acidosis (RTA), the lower part of the kidney tubules is affected. This part is involved in the secretion of acid. Decreased secretion of acid leads to acidosis.

• It could be inherited due to abnormal genes or it could occur as a part of other diseases like Sjogren's syndrome, lupus, liver disease, sickle cell anemia, thyroid or parathyroid disease, or certain kidney diseases.
• Some patients with defective genes and Type 1 RTA may develop deafness.
• The patients also suffer from low potassium level. This could cause complications like muscle weakness and paralysis, and abnormal heart rhythm.
• Other complications include growth retardation, kidney stones, kidney failure and bone disease (rickets in children and osteomalacia in adults).
• Some patients suffer from incomplete distal RTA. In this condition, the blood pH is normal, but the urine pH is low. The patients shows excess calcium and low citrate in the urine, and are unable to acidify the urine when they are administered high doses of oral ammonium chloride or calcium chloride.
• Alkalis like sodium bicarbonate or potassium citrate or sodium citrate are used to treat patients with distal renal tubular acidosis are treated. Other electrolyte levels like calcium and potassium usually come back to normal with this treatment. Early treatment helps to prevent complications. Some infants may need potassium in addition to the alkali.