The syndrome of renal tubular acidosis in some one of its various forms should be suspected when an infant or child has failure to thrive, metabolic acidosis, constipation, diarrhea, vomiting, anorexia, polyuria, or dehydra tion in infancy. Confirmatory biochemical findings include an inappropriately high urinary pH, inadequate acid excretion and/or abnormal tubular reab sorption of filtered bicarbonate.
Growth can be normal when there is sustained correction of the metabolic acidosis through appropriate alkaline therapy.
Get full access to this article
View all access options for this article.
References
1.
Chan, J.C.M. : The influence of dietary intake on endogenous acid production. Nutr. Metabol.16: 1, 1974.
2.
Morris, R.C. , Jr., and Fudenberg , H.: Impaired renal acidification in patients with hypergammaglobulinemias. Medicine46: 57, 1967.
3.
Nash, M.A., Torrado, A.D., Greifer, I., Spitzer, A., and Edelmann, C.M., Jr.: Renal tubular acidosis in infants and children. J. Pediatr.80: 738, 1972.
4.
Morris, R.C. , Jr., Sebastian, A., and McSherry, E.: Renal acidosis. Kidney Int.1: 322, 1972.
5.
McSherry, E. , Sebastian, A., and Morris, R.C., Jr.: Renal tubular acidosis in infants: the several kinds, including bicarbonate-wasting, classical renal tubular acidosis. J. Clin. Invest.51: 499, 1972.
6.
Gyory, A.Z., and Edwards, K.D.G.: Renal tubular acidosis: a family with an autosomal dominant genetic defect in renal hydrogen ion transport, with proximal tubular and collecting duct dysfunction and increased metabolism of citrate and ammonia. Am. J. Med.45: 43, 1968.
7.
Chan, J.C.M. , Grushkin, C.M., Malekzadeh, M., Better, O., and Fine, R.N.: On the adaptation of hydrogen ion excretion associated with nephron reduction in posttransplant patients. Pediatr. Res.7: 712, 1973.
McSherry, E. , Sebastian, A., and Morris, R.C. Jr.: Correction of impaired growth in children with classic renal tubular acidosis (cRTA) by sustained correction of acidosis . Clin. Res.21: 229, 1973.
10.
Muldoney, F.P. , Freaney, R., and Geany, D.: Renal tubular disorders in clinical osteomalacia, the effect of vitamin D and parathyroid extract. Proc. Third Int. Cong. Neph. Basel and New York, 1967.
11.
Ferris, T., Kashgarian, M., Levitin, H., Braudt, I., and Epstein, F.H.: Renal tubular acidosis and renal potassium wasting acquired as a result of hypercalcemic nephropathy. N. Engl. J. Med.265: 924, 1961.
12.
McCurdy, D.K. , Frederic, M., and Elkinton, J.R.: Renal tubular acidosis due to amphotericine B. N. Engl. J. Med.278: 124, 1968.
13.
Seldin, D.W., and Wilson, J.C.: Renal Tubular Acidosis. The Metabolic Basis of Inherited Diseases, 3rd ed. Stanbury, J., Wyngaarden, J., and Fredricson, D., Eds. New York, McGraw Hill Book Co., Inc., 1972, p. 1548.
14.
Rodriguez-Soriano, J., Boichis, H., and Edelmann, C.M., Jr.: Bicarbonate reabsorption and hydrogen ion excretion in children with renal tubular acidosis. J. Pediatr.71: 802, 1967.
15.
Shapira, E. , Ben-Yoseph, Y., Eyal, F.G., and Russell, A.: Enzymatically inactive red cell carbonic anhydrase B in a family with renal tubular acidosis. J. Clin. Invest.53: 59, 1974.
16.
Rodriguez-Soriano, J., Boichis, H., Stark, H., and Edelmann, C.M., Jr.: Proximal renal tubular acidosis: a defect in bicarbonate reabsorption with normal urinary acidification, Pediatr. Res.1: 81, 1967.
17.
Buckalew, V. , McCurdy, D., Ludwig, G., Chaykin, L., and Elkinton, R.: Incomplete renal tubular acidosis. Am. J. Med.45: 32, 1968.
18.
Wrong, O., and Davies, H.E.F.: The excretion of acid in renal disease. Q. J. Med.28: 259, 1959.
19.
Chan, J.C.M. , Grushkin, C.M., and Fine, R.N.: Effect of acidosis on rate of urinarv calcium excretion in transplanted human kidney. Urology2: 444, 1973.
20.
—, Ma, R.S., Malekzadeh, M.H., Hurley, J.K., and Chaimovitz , C.: Renal response to acute ammonium chloride acidosis in subjects with single kidney. J. Urol.3: 315, 1974.
21.
Lin, S.L., and Chan, J.C.M.: Urinary bicarbonate: a titrimetric method for determination. Clin. Biochem.6: 207, 1973.
22.
Edelmann, C.M. , Jr., Boichis, H., Rodriguez-Soriano , J., and Stark, H.: The renal response of children to acute ammonium chloride acidosis. Pediatr. Res.1: 452, 1967.
23.
Rodriguez-Soriano, J., and Edelmann, C.M., Jr.: Renal tubular acidosis. Ann. Rev. Med.20: 363, 1969.