Renal tubular acidosis classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
Classification
Renal tubular acidosis can be classified into 4 types. Renal tubular acidosis type 1( distal), renal tubular acidosis type 2 ( proximal), hypoaldosteronism (type 4) and voltage-dependent RTA. Potassium is the most common electrolyte abnormality associated renal tubular acidosis. Hypokalemia is seen in RTA type 1 and type 2 while type 4 and voltage-dependent RTA are hyperkalemic.
Type of RTA | Primary defect | Plasma HCO3 mEq/L | Urine pH | Plasma potassium | Urine anion gap | Urine calcium/creatinine ratio | Risk for nephrolithiasis |
---|---|---|---|---|---|---|---|
RTA type 1 | Impaired distal acidification | < 10 | >5.3 | Hypokalemic | Positive | ↑ | ↑ |
RTA Type 2 | Reduced proximal HCO3 reabsorption. | 12 to 20 | <5.3 | Hypokalemic | Negative | Normal | - |
RTA type 4 | Decreased aldosterone secretion
Aldosterone resistance |
>17 | Variable | Hyperkalemia | Positive | Normal | - |
Voltage-dependent RTA | Reduced sodium reabsorption | >17 | Variable | Hyperkalemia | Positive | Normal | - |