Renal Tubular Acidosis Flashcards Preview

COMLEX 2 > Renal Tubular Acidosis > Flashcards

Flashcards in Renal Tubular Acidosis Deck (15)
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1
Q

types

A

distal renal tubular acidosis (type 1)
proximal renal tubular acidosis (type 2)
hyperkalemic tubular acidosis (type 4)

2
Q

defect in type 1 renal tubular acidosis

A

inability of α-intercalated cells to secrete H+ -> no new HCO3- is generated -> metabolic acidosis

3
Q

urine pH in type 1 RTA

A

> 5.5

4
Q

serum K in type 1 RTA

A

decrease

5
Q

causes of type 1 RTA

A

amphotericin B toxicity, analgesic nephropathy, congenital anomalies (obstruction) of urinary tract, autoimmune diseases (SLE)

6
Q

associations with type 1 RTA

A

increase risk for calcium phosphate kidney stones (due to increase urine pH and increase bone turnover)

7
Q

defect in type 2 RTA

A

defect in PCT HCO3- reabsorption -> increase excretion of HCO3- in urine -> metabolic acidosis
urine can be acidified by α-intercalated cells in collecting duct, but not enough to overcome the increased excretion of HCO3- -> metabolic acidosis

8
Q

urine pH in type 2 RTA

A

< 5.5

9
Q

serum K in type 2 RTA

A

decrease

10
Q

causes of type 2 RTA

A

fanconi syndrome, multiple myeloma, carbonic anhydrase inhibitors

11
Q

associations of type 2 RTA

A

increase risk for hypophosphatemic rickets (in Fanconi syndrome)

12
Q

defect in type 4 RTA

A

hypoaldosteronism or aldosterone resistance; hyperK -> decrease NH3 synthesis in PCT -> decrease NH4+ excretion

13
Q

urine pH in type 4 RTA

A

< 5.5 (or variable)

14
Q

serum K in type 4 RTA

A

increase

15
Q

cauess of type 4 RTA

A

decrease aldosterone production from diabetic hyporenism, ACEi, ARBs, NSAIDs, heparin, cyclosporine, adrenal insufficiency or aldosterone resistance (K+ sparing diuretics, nephropathy due to obstruction, TMP-SMX)