Acidosis, Renal Tubular

Incidence in USA: Unknown

Present in a variety of disease states, from mild to severe systemic illness

Hemodynamic instability (related to arteriolar vasodilation, acidosis, and decreased cardiac output)

Hyperkalemia

Insulin resistance and hyperglycemia

Acute respiratory failure

Decreased responsiveness to vasopressors and inotropes

Decreased activity of local anesthetic agents

Arrhythmias

RTA is a type of metabolic acidosis that is due to either abnormal bicarbonate loss or acid excretion by the kidneys in presence of a normal or near normal glomerular filtration rate.

Results in non-anion gap metabolic acidosis.

Metabolic acidosis not due to gastrointestinal bicarbonate loss or acute/chronic renal insufficiency.

Related to either proximal tubule dysfunction of bicarbonate reabsorption, failure of distal tubule excretion of acid, or mineralocorticoid deficiency.

Other findings may include recurrent nephrocalcinosis, growth retardation, and osteomalacia/rickets in children.

Can be either inherited, transient, or acquired.