Renal Tubular Acidosis Types, Causes, Symptoms, And Diagnosis

Renal tubular acidosis (RTA) is a clinical problem in which the kidneys do not filter acids, a waste product, from the blood and excrete it as urine. As a result, the blood's acidity level rises too high, a condition known as acidosis. Kidneys usually remove acids from the blood during excretion, preserving the body's acid-base equilibrium problems. A disruption of this mechanism causes acid buildup in the blood, leading to various complications and health issues.

What is Renal Tubular Acidosis?

Types of Renal Tubular Acidosis

Symptoms of Renal Tubular Acidosis

• Extreme fatigue
• Erratic pulse rate
• Paralysis

• Arrhythmia or palpitations in the heart
• Pain in the chest or abdomen
• Diarrhea, vomiting, or nausea
• Limb numbness or weakening of the muscles

What Are the Complications of RTA?

Type 1 RTA

• Children with Type 1 RTA may have inadequate growth and development issues.
• Adults with the condition experience progressive kidney disease and bone disorders.
• Untreated Type 1 RTA in adults and children increases the risk of kidney stones due to abnormal calcium deposition.

Type 2 RTA

• Both children and adults may develop dental disease and the bone disorder rickets.
• Type 2 RTA treatment with alkali may result in the development of a very low potassium level.

Type 4 RTA

• High blood potassium levels in type 4 RTA patients can cause cardiac arrest, sluggish or irregular heartbeats, and muscle weakness.

Causes of Renal Tubular Acidosis

• Type 1 or Type 2 RTA may be hereditary. Scientists have identified distinct genes that could be potentially responsible for the inherited form of this illness.
• An autoimmune condition that affects several body parts, such as lupus or Sjögren's syndrome, may also promote RTA by making it more difficult for your blood to rid itself of acid.
• Chronic exposure to cadmium or acute lead poisoning might also result in Type 2 RTA.
• RTA can also happen to patients receiving treatment for HIV, viral hepatitis, glaucoma, migraines, convulsions, and chemotherapy.
• Some medications obstructing the kidneys' ability to transfer electrolytes from your blood to urine can be responsible for type 4 RTA.

Diagnosis of RTA

• • The doctor may advise blood tests to check for electrolytes, specifically bicarbonate, sodium, potassium, and chlorine content in the blood.
  • The urine test analyses the ammonia, other electrolyte levels, and acidity.

• Blood levels of aldosterone and associated hormones may be measured if type 4 RTA is suspected.

• Medical professionals may also administer a dosage of steroids, diuretics, or salt solution to determine whether your kidneys are responding correctly by excreting more acids.
• Your healthcare professional may occasionally give you an IV of bicarbonate and test the acidity of your urine to differentiate between type 1 and type 2 RTA.

Treatment of Renal Tubular Acidosis

• • Sodium bicarbonate can be administered orally or intravenously to help neutralize the acid in the blood.
  • Infants with distal RTA may be given potassium supplements to regain their potassium levels.
  • Older children and adults may undergo alkali therapy to prevent the kidneys from eliminating potassium from the urine.
  • To maintain the health of their bones, adults with proximal RTA may also need to take vitamin D supplements.

• Steroid hormone therapy may be necessary for Type 4 RTA patients to replace the missing aldosterone.

• Dietary adjustments with limited potassium intake and preventing dehydration can also help maintain proper mineral levels in the blood.