Distal Renal Tubular Acidosis
Distal RTA is the true ...
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Description

Distal Renal Tubular Acidosis

Distal RTA is the true Nephrogenic RTA and can be truly divided into two variants- the hypokalemic and the hyperkalemic types.

Type A intercalated cells - A Low K problem

 • H secretion defect

     - Mutations in the luminal H ATPase

     - AEI mutations (basolateral side)

     - Carbonic anhydrase II defects

     - Autoimmune diseases(Sjogren's Syndrome)

     - Analgesic Nephropathy

     - Sickle cell disease

     - Nephrocalcinosis

     - Drugs( Ifosfamide, topiramate, CA inhibitors)

 • H gradient defect - Back leak via luminal side via holes (amphotericin B induced)

Generalized distal RTA - A high K problem

 • Voltage defect

     - ENaC mutation

     - SCNN mutation

     - Familial Hypokalemic HTN (WNKI and 4 mutations)

     - CNI agents

     - Amiloride and Triamterene use

     - Pentamidine, Trimethoprim

 • Low Mineralocorticoid State

     - Hyporenin Hypoaldosteronism (classic Type IV)

     - NH3 secretion defects

     - Drugs (heparin)

     - DMII

     - Obstructive Uropathy

     - ACEI/ARB



Dr. Kenar Jhaveri @kdjhaveri



#Distal #Renal #Tubular #Acidosis #RTA #diagnosis #differential 
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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