Renal tubular acidosis

Key Information

Appropriate Tests

 

Electrolytes, Ammonia, pH urine.

See also Acidosis - metabolic acidosis

Proximal

Fractional excretion of bicarbonate.

Genetic, including

 

  • Fanconi syndrome
    • Cystinosis
    • Lowe syndrome

Amino acids, Phosphate, Glucose.

Heavy metal poisoning

See Heavy metal exposure/toxicity

Associated with other disease

 

Plasma cell myeloma

 

Sjögren syndrome

 

Vitamin D deficiency

See under Osteomalacia

Amyloidosis

 

Acetazolamide

 

Distal

Urine acidification test.

Genetic

 

Autoimmune

 

  • Sjögren syndrome

 

  • Autoimmune hepatitis

See under Hepatitis - autoimmune

  • Systemic lupus erythematosus (SLE)

 

  • Primary biliary cirrhosis

See under Cholestasis

Hepatic causes

 

  • Cirrhosis

 

Renal causes

 

  • Hypercalciuria / Nephrocalcinosis

Calcium urine.

See Urinary tract calculi

  • Tubulo-interstitial nephropathy

See Renal tubulo-interstitial disorders

  • Obstructive uropathy

See Urinary tract obstruction

  • Renal transplant rejection

 

  • Nephrotic syndrome

 

  • Hyperoxaluria

 

Other

 

  • Primary hyperparathyroidism

 

  • Vitamin D intoxication

See under Hypercalcaemia

  • Sodium depletion with hypovolaemia

Sodium urine.

See Hyponatraemia

  • Diarrhoea

 

  • Drug therapy, especially
    • Amphotericin B
    • Lithium

 

  • Hypoaldosteronism

 

  • Idiopathic