Renal tubular acidosis

Etiology

  • Type I (distal H+ secretion defect): low serum K+, urine pH >5.5, associated with autoimmune disease, hypercalcemia
  • Type II (proximal HCO3- reabosrbtion defect): low serum K+, urine pH < 5.5, associated with multiple myeloma, drugs (eg, sulfa)
  • Type III (rare): normal serum K+, urine pH < 5.5, associated with renal insufficiency
  • Type IV (hyporeninemic hypoaldosteronism): high serum K+, urine pH < 5.5, associated with diabetes mellitus, drugs (eg, NSAIDs)

DDx

Other causes of normal gap metabolic acidosis

  • Gastrointestinal loss of HCO3-, eg, diarrhea, pancreatic ileostomy or ileal loop bladder
  • Renal tubular acidosis
  • Recovery from diabetic ketoacidosis
  • Dilutional acidosis from rapid administration of 0.9% NaCl
  • Carbonic anhydrase inhibitors
  • Chloride retention or administration of HCl equivalent or NH4Cl

See related DDx

Renal tubular acidosis is a sample topic from the Diagnosaurus.

To view other topics, please or purchase a subscription.

Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Learn more.

Last updated: December 1, 2014

Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Renal tubular acidosis ID - 114288 Y1 - 2014/12/01/ PB - Diagnosaurus UR - https://emergency.unboundmedicine.com/emergency/view/Diagnosaurus/114288/all/Renal_tubular_acidosis ER -