Renal tubular acidosis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

If left untreated renal tubular acidosis leads to growth failure and chronic kidney failure. Common complications associated with renal tubular acidosis include volume depletion, electrolyte disturbances, nephrocalcinosis, osteoporosis, growth retardation, renal rickets. Prognosis of renal tubular acidosis is generally good with appropriate therapy.

Natural History

If left untreated renal tubular acidosis leads to growth failure and chronic kidney failure leading to electrolyte disturbances, bone abnormalities, cranial nerve compression and in severe cases it may lead to heart failure and death.

Complications

Common complications associated with renal tubular acidosis include:

• Volume depletion
• Electrolyte disturbances
• Nephrocalcinosis
• Osteoporosis
• Growth retardation
• Renal rickets
• Fludrocortisone-associated hypertension and edema or pulmonary edema
• Osteopetrosis

Prognosis

• Prognosis of renal tubular acidosis is generally good with appropriate therapy.
• Alkali therapy seems effective in prevention of renal stones and nephro-calcinosis in patients with incomplete distal renal tubular acidosis.
• Aggressive correction of acidosis has been shown to restore growth in children with renal tubular acidosis.
• Effective treatment proved no effect on already occurred damage such as blindness and deafness due to nerve compression.
• The prognosis of Fanconi syndrome depend on etiology.
  • In inherited metabolic disease, it is of poor prognosis .
  • When it is secondary due to drugs or toxin exposure, prognosis is generally good as it regresses on with drawl of the offending agent.