Renal tubular acidosis
Contents:
Description:
Renal tubular acidosis — one of rakhitopodobny diseases (primary tubulopatiya) which is characterized by a constant metabolic acidosis, low level of bicarbonates and the increased concentration of chlorine in blood serum.
There are 2 types of this state:
* Type I — distal renal tubular acidosis — Battlera-Albright's syndrome.
* Type II — proximal renal tubular acidosis
Symptoms of Renal tubular acidosis:
Battlera-Albright's syndrome:
Clinical signs begin to be shown from 6-24 months of life. Lag in growth, rakhitopodobny changes in bones, crises of dehydration and a polyuria, a nephrocalcinosis and an urolithiasis, intersticial nephrite, pyelonephritis is shown, damage of an acoustical nerve with the subsequent relative deafness is possible, a heterochromia of an iris of the eye is possible. In blood — a hypopotassemia, a metabolic acidosis. In urine — alkali reaction, reduction of total quantity of excretion of titrable acids and ammonium, excess excretion of potassium, a hypercalcuria (higher than 4 mgkgnut), decrease in concentration ability. On the roentgenogram — symptoms of osteoporosis. The progressing valgus deformation of extremities. Calcificats in a medulla of kidneys. Nephrolithiasis.
Proximal renal tubular acidosis:
Clinical signs begin to be shown about 3-18 months of life. Lag in growth, vomitings, fevers of not clear genesis, rakhitopodobny changes of bones, a polyuria, a polydipsia, a nephrocalcinosis is shown. In blood — a hypochloraemia, a metabolic acidosis. In urine — acid reaction, high excretion of potassium, safe excretion of titrable acids and ammonium, decrease in concentration ability it is less expressed. On the roentgenogram — osteoporosis, a curvature big tibial and femurs. Calcificats in a medulla of kidneys. Nephrolithiasis.
Reasons of Renal tubular acidosis:
Has a hereditary etiology. Battlera-Albright's syndrome: autosomal and recessive, autosomal and dominant or sporadic cases.
Proximal renal tubular acidosis: sporadic cases, are ill boys more often.
Treatment of Renal tubular acidosis:
Potato and cabbage diet, the restriction of proteins of animal origin alkalizing drink. The amount of the consumed liquid is increased to 2,5 lm ² in days. The main directions of treatment — correction of acidosis during the acute period (Natrii hydrocarbonas вв kapelno); correction of a hypopotassemia, correction of a hypocalcemia, treatment of an osteomalation (vitamin D and drugs of calcium).
