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.[1]
Complications
Common complications associated with renal tubular acidosis include:[2][3]
- 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.[4][5]
- 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.
References
- ↑ Laing CM, Unwin RJ (2006). "Renal tubular acidosis". J. Nephrol. 19 Suppl 9: S46–52. PMID 16736441.
- ↑ Tsau YK, Chen CH, Tsai WS, Chiou YM (1990). "Renal tubular acidosis in childhood". Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 31 (4): 205–13. PMID 2264480.
- ↑ Harrington TM, Bunch TW, Van den Berg CJ (June 1983). "Renal tubular acidosis. A new look at treatment of musculoskeletal and renal disease". Mayo Clin. Proc. 58 (6): 354–60. PMID 6222224.
- ↑ Tsau YK, Chen CH, Tsai WS, Chiou YM (1990). "Renal tubular acidosis in childhood". Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 31 (4): 205–13. PMID 2264480.
- ↑ Santos F, Chan JC (1986). "Renal tubular acidosis in children. Diagnosis, treatment and prognosis". Am. J. Nephrol. 6 (4): 289–95. doi:10.1159/000167177. PMID 3777038.