Renal tubular acidosis differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
==Differentiating Renal tubular acidosis from other diseases== | ==Differentiating Renal tubular acidosis from other diseases== | ||
{| | |||
! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | |||
! colspan="2" rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease | |||
! colspan="3" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Mechanism | |||
! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical | |||
! colspan="18" align="center" style="background:#4479BA; color: #FFFFFF;" + |Paraclinical | |||
! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis | |||
! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings | |||
|- | |||
! colspan="4" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Symptoms | |||
! colspan="4" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Signs | |||
! colspan="18" align="center" style="background:#4479BA; color: #FFFFFF;" + |Lab data | |||
|- | |||
! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |ABG | |||
! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |CBC | |||
! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Chemistry | |||
! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal | |||
! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |U/A | |||
|- | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |↑ acid | |||
production | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Loss of | |||
bicarbonate | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |↓ renal acid | |||
excretion | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |N/V | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Diarrhea | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Level of consciousness | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |WBC | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hb | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BS | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ketones | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Lactic acid | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Serum AG<ref>Brubaker RH, Meseeha M. High Anion Gap Metabolic Acidosis. [Updated 2017 Oct 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448090/</ref> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Osmolar gap<ref name="pmid217949663">{{cite journal |vauthors=Kraut JA, Xing SX |title=Approach to the evaluation of a patient with an increased serum osmolal gap and high-anion-gap metabolic acidosis |journal=Am. J. Kidney Dis. |volume=58 |issue=3 |pages=480–4 |date=September 2011 |pmid=21794966 |doi=10.1053/j.ajkd.2011.05.018 |url=}}</ref> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine pH | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine AG | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine ketone | |||
|- | |||
| rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Ketoacidosis | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Diabetic ketoacidosis]]<ref name="WolfsdorfAllgrove2014">{{cite journal|last1=Wolfsdorf|first1=Joseph I|last2=Allgrove|first2=Jeremy|last3=Craig|first3=Maria E|last4=Edge|first4=Julie|last5=Glaser|first5=Nicole|last6=Jain|first6=Vandana|last7=Lee|first7=Warren WR|last8=Mungai|first8=Lucy NW|last9=Rosenbloom|first9=Arlan L|last10=Sperling|first10=Mark A|last11=Hanas|first11=Ragnar|title=Diabetic ketoacidosis and hyperglycemic hyperosmolar state|journal=Pediatric Diabetes|volume=15|issue=S20|year=2014|pages=154–179|issn=1399543X|doi=10.1111/pedi.12165}}</ref> | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↓ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |↑↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |Clinical + [[hyperglycemia]] + [[ketosis]] | |||
| align="left" style="background:#F5F5F5;" + | | |||
*Labs might show elevated K<sup>+</sup> even in K<sup>+</sup> depletion due to extravasation of [[intracellular]] K+ in exchanged with extracellular H<sup>+</sup> | |||
|- | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |Starvation<ref name="pmid27752032">{{cite journal |vauthors=Mostert M, Bonavia A |title=Starvation Ketoacidosis as a Cause of Unexplained Metabolic Acidosis in the Perioperative Period |journal=Am J Case Rep |volume=17 |issue= |pages=755–758 |date=October 2016 |pmid=27752032 |pmc=5070574 |doi= |url=}}</ref> | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |Clinical manifestation | |||
| align="left" style="background:#F5F5F5;" + | | |||
*[[Refeeding syndrome]] may occur during or after treatment | |||
|- | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |Alcoholic ketoacidosis ([[Ethanol]])<ref name="pmid28613672">{{cite journal |vauthors=Howard RD, Bokhari SRA |title= |journal= |volume= |issue= |pages= |date= |pmid=28613672 |doi= |url=}}</ref> | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |± | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ ↑ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |Agitated | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ Nl ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↑↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + [[ketosis]] | |||
| align="left" style="background:#F5F5F5;" + | | |||
*Chronic [[alcohol abuse]] | |||
*Zero or low [[Alcohol|alcohol level]] | |||
|- | |||
| rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Systemic | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Sepsis]]<ref name="pmid28149822">{{cite journal |vauthors=Ganesh K, Sharma RN, Varghese J, Pillai MG |title=A profile of metabolic acidosis in patients with sepsis in an Intensive Care Unit setting |journal=Int J Crit Illn Inj Sci |volume=6 |issue=4 |pages=178–181 |date=2016 |pmid=28149822 |pmc=5225760 |doi=10.4103/2229-5151.195417 |url=}}</ref> | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ ↑ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↓ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |Clinical manifestation and lab finding | |||
| align="left" style="background:#F5F5F5;" + | | |||
*Not applicable | |||
|- | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Ischemia]]<ref name="KimmounNovy2015">{{cite journal|last1=Kimmoun|first1=Antoine|last2=Novy|first2=Emmanuel|last3=Auchet|first3=Thomas|last4=Ducrocq|first4=Nicolas|last5=Levy|first5=Bruno|title=Hemodynamic consequences of severe lactic acidosis in shock states: from bench to bedside|journal=Critical Care|volume=19|issue=1|year=2015|issn=1364-8535|doi=10.1186/s13054-015-0896-7}}</ref> | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |Clinical manifestation and lab finding | |||
| align="left" style="background:#F5F5F5;" + | | |||
*Not applicable | |||
|- | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Lactic acidosis]]<ref name="KrautIngelfinger2014">{{cite journal|last1=Kraut|first1=Jeffrey A.|last2=Ingelfinger|first2=Julie R.|last3=Madias|first3=Nicolaos E.|title=Lactic Acidosis|journal=New England Journal of Medicine|volume=371|issue=24|year=2014|pages=2309–2319|issn=0028-4793|doi=10.1056/NEJMra1309483}}</ref> | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |± | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ ↑ | |||
| align="center" style="background:#F5F5F5;" + |± | |||
| align="center" style="background:#F5F5F5;" + |Agitated | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl or ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |Clinical manifestation and lab finding | |||
| align="left" style="background:#F5F5F5;" + | | |||
*Not applicable | |||
|- | |||
| rowspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Uremia]]<ref name="BrownMelamed2018">{{cite journal|last1=Brown|first1=Denver|last2=Melamed|first2=Michal L.|title=New Frontiers in Treating Uremic Metabolic Acidosis|journal=Clinical Journal of the American Society of Nephrology|volume=13|issue=1|year=2018|pages=4–5|issn=1555-9041|doi=10.2215/CJN.11771017}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ ↑ | |||
| align="center" style="background:#F5F5F5;" + |± | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↓ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |Clinical manifestation and lab finding | |||
| align="left" style="background:#F5F5F5;" + | | |||
*May lead to [[pericarditis]] | |||
|- | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Renal failure]]<ref name="KrautMadias2016">{{cite journal|last1=Kraut|first1=Jeffrey A.|last2=Madias|first2=Nicolaos E.|title=Metabolic Acidosis of CKD: An Update|journal=American Journal of Kidney Diseases|volume=67|issue=2|year=2016|pages=307–317|issn=02726386|doi=10.1053/j.ajkd.2015.08.028}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↓ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |[[Renal function tests|Renal function test]] | |||
| align="left" style="background:#F5F5F5;" + | | |||
*Not applicable | |||
|- | |||
! rowspan="3" align="center" style="background:#DCDCDC;" + |[[Renal tubular acidosis]]<ref name="Gil-PeñaMejía2014">{{cite journal|last1=Gil-Peña|first1=Helena|last2=Mejía|first2=Natalia|last3=Santos|first3=Fernando|title=Renal Tubular Acidosis|journal=The Journal of Pediatrics|volume=164|issue=4|year=2014|pages=691–698.e1|issn=00223476|doi=10.1016/j.jpeds.2013.10.085}}</ref> | |||
! align="center" style="background:#DCDCDC;" + |Type I<ref name="Hemstreet2004">{{cite journal|last1=Hemstreet|first1=Brian A|title=Antimicrobial-Associated Renal Tubular Acidosis|journal=Annals of Pharmacotherapy|volume=38|issue=6|year=2004|pages=1031–1038|issn=1060-0280|doi=10.1345/aph.1D573}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |± | |||
| align="center" style="background:#F5F5F5;" + |± | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |↓ ↑ | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |Clinical manifestation and lab finding | |||
| align="left" style="background:#F5F5F5;" + | | |||
*Associated with [[Autoimmunity|autoimmune diseases]] | |||
*[[Delayed milestone|Growth retardation]] in children | |||
|- | |||
! align="center" style="background:#DCDCDC;" + |Type II | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |± | |||
| align="center" style="background:#F5F5F5;" + |± | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |↓ ↑ | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |Clinical manifestation and lab finding | |||
| align="left" style="background:#F5F5F5;" + | | |||
*Not applicable | |||
|- | |||
! align="center" style="background:#DCDCDC;" + |Type IV | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |± | |||
| align="center" style="background:#F5F5F5;" + |± | |||
| align="center" style="background:#F5F5F5;" + |± | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |Clinical manifestation and lab finding | |||
| align="left" style="background:#F5F5F5;" + | | |||
*[[Hypoaldosteronism]] | |||
|- | |||
| rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Heart | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Heart failure]]<ref name="ParkChoi2015">{{cite journal|last1=Park|first1=Jin Joo|last2=Choi|first2=Dong-Ju|last3=Yoon|first3=Chang-Hwan|last4=Oh|first4=Il-Young|last5=Lee|first5=Ju Hyun|last6=Ahn|first6=Soyeon|last7=Yoo|first7=Byung-Su|last8=Kang|first8=Seok-Min|last9=Kim|first9=Jae-Joong|last10=Baek|first10=Sang-Hong|last11=Cho|first11=Myeong-Chan|last12=Jeon|first12=Eun-Seok|last13=Chae|first13=Shung Chull|last14=Ryu|first14=Kyu-Hyung|last15=Oh|first15=Byung-Hee|title=The prognostic value of arterial blood gas analysis in high-risk acute heart failure patients: an analysis of the Korean Heart Failure (KorHF) registry|journal=European Journal of Heart Failure|volume=17|issue=6|year=2015|pages=601–611|issn=13889842|doi=10.1002/ejhf.276}}</ref> | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |± | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ ↑ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ ↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |Clinical manifestation+ [[echocardiogram]] | |||
| align="left" style="background:#F5F5F5;" + | | |||
*[[Hypoalbuminemia]] | |||
*Elevated [[Natriuretic peptides|serum natriuretic peptide]] | |||
|- | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Myocardial infarction]]<ref name="MannBajulaiye2014">{{cite journal|last1=Mann|first1=Sarah|last2=Bajulaiye|first2=Akinyemi|last3=Sturgeon|first3=Kathleen|last4=Sabri|first4=Abdelkarim|last5=Muthukumaran|first5=Geetha|last6=Libonati|first6=Joseph R.|title=Effects of acute angiotensin II on ischemia reperfusion injury following myocardial infarction|journal=Journal of the Renin-Angiotensin-Aldosterone System|volume=16|issue=1|year=2014|pages=13–22|issn=1470-3203|doi=10.1177/1470320314554963}}</ref> | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ ↑ | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + [[ECG]] | |||
| align="left" style="background:#F5F5F5;" + | | |||
*Not applicable | |||
|- | |||
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |GI | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Diarrhea]]<ref name="GuerrantVan Gilder2001">{{cite journal|last1=Guerrant|first1=R. L.|last2=Van Gilder|first2=T.|last3=Steiner|first3=T. S.|last4=Thielman|first4=N. M.|last5=Slutsker|first5=L.|last6=Tauxe|first6=R. V.|last7=Hennessy|first7=T.|last8=Griffin|first8=P. M.|last9=DuPont|first9=H.|last10=Bradley Sack|first10=R.|last11=Tarr|first11=P.|last12=Neill|first12=M.|last13=Nachamkin|first13=I.|last14=Reller|first14=L. B.|last15=Osterholm|first15=M. T.|last16=Bennish|first16=M. L.|last17=Pickering|first17=L. K.|title=Practice Guidelines for the Management of Infectious Diarrhea|journal=Clinical Infectious Diseases|volume=32|issue=3|year=2001|pages=331–351|issn=1058-4838|doi=10.1086/318514}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |± | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |May be lethargic | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |[[Stool examination|Stool exam]] | |||
| align="left" style="background:#F5F5F5;" + | | |||
*Not applicable | |||
|- | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hyperalimentation]]<ref name="ErlingssonHerard2009">{{cite journal|last1=Erlingsson|first1=Styrbjörn|last2=Herard|first2=Sebastian|last3=Dahlqvist Leinhard|first3=Olof|last4=Lindström|first4=Torbjörb|last5=Länne|first5=Toste|last6=Borga|first6=Magnus|last7=Nystrom|first7=Fredrik H.|title=Men develop more intraabdominal obesity and signs of the metabolic syndrome after hyperalimentation than women|journal=Metabolism|volume=58|issue=7|year=2009|pages=995–1001|issn=00260495|doi=10.1016/j.metabol.2009.02.028}}</ref> | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |Clinical manifestation | |||
| align="left" style="background:#F5F5F5;" + | | |||
*Not applicable | |||
|- | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Liver failure]]<ref name="LangeBojunga2009">{{cite journal|last1=Lange|first1=Christian M.|last2=Bojunga|first2=Jörg|last3=Hofmann|first3=Wolf Peter|last4=Wunder|first4=Katrin|last5=Mihm|first5=Ulrike|last6=Zeuzem|first6=Stefan|last7=Sarrazin|first7=Christoph|title=Severe lactic acidosis during treatment of chronic hepatitis B with entecavir in patients with impaired liver function|journal=Hepatology|volume=50|issue=6|year=2009|pages=2001–2006|issn=02709139|doi=10.1002/hep.23346}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |Confused | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ ↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |[[Liver biopsy]] | |||
| align="left" style="background:#F5F5F5;" + | | |||
*Not applicable | |||
|- | |||
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Endocrine | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hyperparathyroidism]]<ref name="BilezikianPotts2002">{{cite journal|last1=Bilezikian|first1=John P.|last2=Potts|first2=John T.|last3=Fuleihan|first3=Ghada El-Hajj|last4=Kleerekoper|first4=Michael|last5=Neer|first5=Robert|last6=Peacock|first6=Munro|last7=Rastad|first7=Jonas|last8=Silverberg|first8=Shonni J.|last9=Udelsman|first9=Robert|last10=Wells|first10=Samuel A.|title=Summary Statement from a Workshop on Asymptomatic Primary Hyperparathyroidism: A Perspective for the 21st Century|journal=The Journal of Clinical Endocrinology & Metabolism|volume=87|issue=12|year=2002|pages=5353–5361|issn=0021-972X|doi=10.1210/jc.2002-021370}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |Confused | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |[[Parathyroid hormone|PTH]] level | |||
| align="left" style="background:#F5F5F5;" + | | |||
*Not applicable | |||
|- | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Addison's disease]]<ref name="TenNew2001">{{cite journal|last1=Ten|first1=Svetlana|last2=New|first2=Maria|last3=Maclaren|first3=Noel|title=Addison’s Disease 2001|journal=The Journal of Clinical Endocrinology & Metabolism|volume=86|issue=7|year=2001|pages=2909–2922|issn=0021-972X|doi=10.1210/jcem.86.7.7636}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |Irritable | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |[[Hormone]] level | |||
| align="left" style="background:#F5F5F5;" + | | |||
*[[Weakness]] | |||
*[[Hyperpigmentation]] | |||
*[[Adrenal crisis|Adrenal Crisis]] | |||
|} | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 15:29, 26 July 2018
|
Renal tubular acidosis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Renal tubular acidosis differential diagnosis On the Web |
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American Roentgen Ray Society Images of Renal tubular acidosis differential diagnosis |
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Risk calculators and risk factors for Renal tubular acidosis differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
Differentiating Renal tubular acidosis from other diseases
| Category | Disease | Mechanism | Clinical | Paraclinical | Gold standard diagnosis | Other findings | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Signs | Lab data | |||||||||||||||||||||||||||||||
| ABG | CBC | Chemistry | Renal | U/A | |||||||||||||||||||||||||||||
| ↑ acid
production |
Loss of
bicarbonate |
↓ renal acid
excretion |
Fever | N/V | Diarrhea | Dyspnea | Toxic/ill | BP | Dehydration | Level of consciousness | HCO3− | paCO2 | O2 | WBC | Hb | BS | Cl− | K+ | Na+ | Ketones | Lactic acid | Serum AG[1] | Osmolar gap[2] | Bun | Cr | Urine pH | Urine AG | Urine ketone | |||||
| Ketoacidosis | Diabetic ketoacidosis[3] | + | − | − | + | + | + | + | + | ↓ | + | ↓ | ↓ | ↓ | Nl to ↓ | ↑ | Nl to ↑ | ↑↑ | Nl | ↑ | ↓ | ↑ | ↑ | ↑ | ↑ | Nl to ↑ | Nl | ↓ | + | + | Clinical + hyperglycemia + ketosis |
| |
| Starvation[4] | + | − | − | − | + | − | − | + | ↓ | + | ↓ | ↓ | ↓ | Nl | Nl | Nl | Nl to ↓ | Nl | ↓ | ↓ | ↑ | Nl | ↑ | Nl | Nl | Nl | Nl | + | − | Clinical manifestation |
| ||
| Alcoholic ketoacidosis (Ethanol)[5] | + | − | − | − | + | ± | − | + | ↓ ↑ | + | Agitated | ↓ | ↓ | ↓ | Nl to ↑ | Nl to ↑ | ↓ Nl ↑ | Nl | ↓ | ↓ | ↑↑ | ↑ | ↑ | ↑↑ | ↑ | Nl | ↓ | + | + | Clinical manifestation + ketosis |
| ||
| Systemic | Sepsis[6] | + | − | − | + | + | − | + | + | ↓ ↑ | + | ↓ | ↓ | ↓ | Nl to ↓ | ↑ | Nl | Nl | Nl | ↑ | ↓ | Nl | Nl to ↑ | Nl | Nl | ↑ | ↑ | Nl | − | − | Clinical manifestation and lab finding |
| |
| Ischemia[7] | + | − | − | − | + | − | + | + | ↓ | + | − | ↓ | ↓ ↑ | Nl to ↓ | Nl to ↑ | Nl | Nl | Nl | ↑ | ↓ | Nl | Nl to ↑ | Nl | Nl | Nl to ↑ | Nl to ↑ | Nl | − | − | Clinical manifestation and lab finding |
| ||
| Lactic acidosis[8] | + | − | − | ± | + | − | − | + | ↓ ↑ | ± | Agitated | ↓ | ↓ | ↓ | Nl to ↑ | ↓ | Nl | Nl | Nl | Nl | Nl | ↑ | ↑ | ↑ | Nl or ↑ | Nl | ↓ | − | − | Clinical manifestation and lab finding |
| ||
| Renal | Uremia[9] | − | − | + | + | + | − | − | + | ↓ ↑ | ± | ↓ | ↓ | ↓ | Nl to ↓ | ↑ | ↓ | Nl | Nl | ↑ | ↑ | Nl | Nl | ↑ | ↑ | ↑ | ↑ | ↓ | + | − | Clinical manifestation and lab finding |
| |
| Renal failure[10] | − | − | + | − | + | − | − | + | ↓ | + | ↓ | ↓ | ↓ | Nl to ↓ | ↑ | ↓ | Nl | ↑ | ↑ | ↓ | Nl | Nl | ↑ | ↑ | ↑ | ↑ | ↓ | − | − | Renal function test |
| ||
| Renal tubular acidosis[11] | Type I[12] | − | − | + | ± | ± | − | − | − | ↓ ↑ | − | − | ↓ | ↓ | Nl | Nl | Nl | Nl | ↑ | ↓ | ↓ | Nl | Nl | Nl | Nl | ↑ | ↑ | ↑ | + | − | Clinical manifestation and lab finding |
| |
| Type II | − | + | − | ± | ± | − | − | − | ↓ ↑ | − | − | ↓ | ↓ | Nl | Nl | Nl | Nl | ↑ | ↓ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | − | − | Clinical manifestation and lab finding |
| ||
| Type IV | − | − | + | ± | ± | ± | − | − | ↓ | − | − | ↓ | ↓ | Nl | Nl | Nl | Nl | ↑ | ↑ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | + | − | Clinical manifestation and lab finding | |||
| Heart | Heart failure[13] | + | + | − | − | ± | − | + | + | ↓ ↑ | + | − | ↓ | ↓ ↑ | ↓ | Nl | Nl | Nl | Nl | ↓ | ↓ | Nl | Nl | Nl | Nl | Nl to ↑ | Nl to ↑ | Nl | − | − | Clinical manifestation+ echocardiogram |
| |
| Myocardial infarction[14] | + | − | − | − | + | − | + | + | ↓ ↑ | − | ↓ | ↓ | ↓ ↑ | Nl to ↓ | Nl to ↑ | Nl | Nl | Nl | ↑ | ↓ | Nl | ↑ | Nl | Nl | Nl to ↑ | Nl to ↑ | Nl | − | − | Clinical manifestation + ECG |
| ||
| GI | Diarrhea[15] | − | + | − | ± | + | + | − | + | ↓ | + | May be lethargic | ↓ | ↓ | Nl | Nl | ↓ | ↓ | ↑ | ↑ | Nl | Nl | Nl | Nl | Nl | ↑ | Nl | Nl | − | − | Stool exam |
| |
| Hyperalimentation[16] | + | + | − | − | − | + | − | − | Nl | − | − | ↓ | ↓ | Nl | Nl | ↓ | Nl | ↑ | ↑ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | − | − | Clinical manifestation |
| ||
| Liver failure[17] | − | + | − | − | + | + | − | + | ↓ | + | Confused | ↓ | ↓ | Nl | Nl | ↓ | ↓ ↑ | ↑ | ↓ | ↓ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | − | − | Liver biopsy |
| ||
| Endocrine | Hyperparathyroidism[18] | − | + | + | − | + | − | − | − | Nl | + | Confused | ↓ | ↓ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl | Nl to ↑ | Nl | Nl | − | − | PTH level |
| |
| Addison's disease[19] | − | + | − | − | + | + | − | − | ↓ | + | Irritable | ↓ | ↓ | Nl | Nl | Nl | ↓ | Nl | ↑ | ↓ | Nl | Nl | Nl | Nl | Nl | Nl | Nl | − | − | Hormone level | |||
References
- ↑ Brubaker RH, Meseeha M. High Anion Gap Metabolic Acidosis. [Updated 2017 Oct 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448090/
- ↑ Kraut JA, Xing SX (September 2011). "Approach to the evaluation of a patient with an increased serum osmolal gap and high-anion-gap metabolic acidosis". Am. J. Kidney Dis. 58 (3): 480–4. doi:10.1053/j.ajkd.2011.05.018. PMID 21794966.
- ↑ Wolfsdorf, Joseph I; Allgrove, Jeremy; Craig, Maria E; Edge, Julie; Glaser, Nicole; Jain, Vandana; Lee, Warren WR; Mungai, Lucy NW; Rosenbloom, Arlan L; Sperling, Mark A; Hanas, Ragnar (2014). "Diabetic ketoacidosis and hyperglycemic hyperosmolar state". Pediatric Diabetes. 15 (S20): 154–179. doi:10.1111/pedi.12165. ISSN 1399-543X.
- ↑ Mostert M, Bonavia A (October 2016). "Starvation Ketoacidosis as a Cause of Unexplained Metabolic Acidosis in the Perioperative Period". Am J Case Rep. 17: 755–758. PMC 5070574. PMID 27752032.
- ↑ Howard RD, Bokhari S. PMID 28613672. Vancouver style error: initials (help); Missing or empty
|title=(help) - ↑ Ganesh K, Sharma RN, Varghese J, Pillai MG (2016). "A profile of metabolic acidosis in patients with sepsis in an Intensive Care Unit setting". Int J Crit Illn Inj Sci. 6 (4): 178–181. doi:10.4103/2229-5151.195417. PMC 5225760. PMID 28149822.
- ↑ Kimmoun, Antoine; Novy, Emmanuel; Auchet, Thomas; Ducrocq, Nicolas; Levy, Bruno (2015). "Hemodynamic consequences of severe lactic acidosis in shock states: from bench to bedside". Critical Care. 19 (1). doi:10.1186/s13054-015-0896-7. ISSN 1364-8535.
- ↑ Kraut, Jeffrey A.; Ingelfinger, Julie R.; Madias, Nicolaos E. (2014). "Lactic Acidosis". New England Journal of Medicine. 371 (24): 2309–2319. doi:10.1056/NEJMra1309483. ISSN 0028-4793.
- ↑ Brown, Denver; Melamed, Michal L. (2018). "New Frontiers in Treating Uremic Metabolic Acidosis". Clinical Journal of the American Society of Nephrology. 13 (1): 4–5. doi:10.2215/CJN.11771017. ISSN 1555-9041.
- ↑ Kraut, Jeffrey A.; Madias, Nicolaos E. (2016). "Metabolic Acidosis of CKD: An Update". American Journal of Kidney Diseases. 67 (2): 307–317. doi:10.1053/j.ajkd.2015.08.028. ISSN 0272-6386.
- ↑ Gil-Peña, Helena; Mejía, Natalia; Santos, Fernando (2014). "Renal Tubular Acidosis". The Journal of Pediatrics. 164 (4): 691–698.e1. doi:10.1016/j.jpeds.2013.10.085. ISSN 0022-3476.
- ↑ Hemstreet, Brian A (2004). "Antimicrobial-Associated Renal Tubular Acidosis". Annals of Pharmacotherapy. 38 (6): 1031–1038. doi:10.1345/aph.1D573. ISSN 1060-0280.
- ↑ Park, Jin Joo; Choi, Dong-Ju; Yoon, Chang-Hwan; Oh, Il-Young; Lee, Ju Hyun; Ahn, Soyeon; Yoo, Byung-Su; Kang, Seok-Min; Kim, Jae-Joong; Baek, Sang-Hong; Cho, Myeong-Chan; Jeon, Eun-Seok; Chae, Shung Chull; Ryu, Kyu-Hyung; Oh, Byung-Hee (2015). "The prognostic value of arterial blood gas analysis in high-risk acute heart failure patients: an analysis of the Korean Heart Failure (KorHF) registry". European Journal of Heart Failure. 17 (6): 601–611. doi:10.1002/ejhf.276. ISSN 1388-9842.
- ↑ Mann, Sarah; Bajulaiye, Akinyemi; Sturgeon, Kathleen; Sabri, Abdelkarim; Muthukumaran, Geetha; Libonati, Joseph R. (2014). "Effects of acute angiotensin II on ischemia reperfusion injury following myocardial infarction". Journal of the Renin-Angiotensin-Aldosterone System. 16 (1): 13–22. doi:10.1177/1470320314554963. ISSN 1470-3203.
- ↑ Guerrant, R. L.; Van Gilder, T.; Steiner, T. S.; Thielman, N. M.; Slutsker, L.; Tauxe, R. V.; Hennessy, T.; Griffin, P. M.; DuPont, H.; Bradley Sack, R.; Tarr, P.; Neill, M.; Nachamkin, I.; Reller, L. B.; Osterholm, M. T.; Bennish, M. L.; Pickering, L. K. (2001). "Practice Guidelines for the Management of Infectious Diarrhea". Clinical Infectious Diseases. 32 (3): 331–351. doi:10.1086/318514. ISSN 1058-4838.
- ↑ Erlingsson, Styrbjörn; Herard, Sebastian; Dahlqvist Leinhard, Olof; Lindström, Torbjörb; Länne, Toste; Borga, Magnus; Nystrom, Fredrik H. (2009). "Men develop more intraabdominal obesity and signs of the metabolic syndrome after hyperalimentation than women". Metabolism. 58 (7): 995–1001. doi:10.1016/j.metabol.2009.02.028. ISSN 0026-0495.
- ↑ Lange, Christian M.; Bojunga, Jörg; Hofmann, Wolf Peter; Wunder, Katrin; Mihm, Ulrike; Zeuzem, Stefan; Sarrazin, Christoph (2009). "Severe lactic acidosis during treatment of chronic hepatitis B with entecavir in patients with impaired liver function". Hepatology. 50 (6): 2001–2006. doi:10.1002/hep.23346. ISSN 0270-9139.
- ↑ Bilezikian, John P.; Potts, John T.; Fuleihan, Ghada El-Hajj; Kleerekoper, Michael; Neer, Robert; Peacock, Munro; Rastad, Jonas; Silverberg, Shonni J.; Udelsman, Robert; Wells, Samuel A. (2002). "Summary Statement from a Workshop on Asymptomatic Primary Hyperparathyroidism: A Perspective for the 21st Century". The Journal of Clinical Endocrinology & Metabolism. 87 (12): 5353–5361. doi:10.1210/jc.2002-021370. ISSN 0021-972X.
- ↑ Ten, Svetlana; New, Maria; Maclaren, Noel (2001). "Addison's Disease 2001". The Journal of Clinical Endocrinology & Metabolism. 86 (7): 2909–2922. doi:10.1210/jcem.86.7.7636. ISSN 0021-972X.