Renal Tubular Acidosis (RTA)

Renal Tubular Acidosis (RTA) is a disorder in which the kidneys fail to properly remove acid from the body, causing blood acidity to rise abnormally. It occurs despite normal glomerular function and results in a non-anion gap metabolic acidosis. The condition arises from defects in the renal tubules—either an inability to secrete hydrogen ions or impaired reabsorption of bicarbonate. There are three main types: Type 1 (distal RTA), where the distal tubules fail to remove acid; Type 2 (proximal RTA), involving defective bicarbonate reabsorption; and Type 4 RTA, linked to hypoaldosteronism and hyperkalemia.

Symptoms can include muscle weakness, bone pain, kidney stones, and growth problems in children. Diagnosis involves blood and urine tests to assess pH and kidney function. Treatment focuses on correcting acid-base imbalance through alkali replacement therapy (bicarbonate or citrate supplements) and managing underlying causes such as autoimmune diseases, medications, or genetic disorders. Early management prevents complications like nephrocalcinosis and chronic kidney damage, improving patient outcomes.