Renal tubular acidosis and stone formation

Abstract

© Springer-Verlag London 2012. All rights reserved. Distal renal tubular acidosis (RTA) syndrome is a condition caused by the acidi fi cation defect in collection tubule. The syndrome is characterized by a persistent hyperchloremic, normal plasma anion gap and metabolic acidosis in patients with relatively normal glomerular fi ltration rate (GFR). Hypokalemiais also common. Most patients are associated with recurrent calcium oxalate or calcium phosphate stone formation and nephrocalcinosis. Metabolic bone disease and growth retardation are common complications. Occasionally, patients may present with hypokalemic paralysis. The treatment aims to provide adequate alkaline therapy to neutralize the daily acid production. All the associated complications should be prevented. Monitoring of urinary parameters such as calcium-to-creatinine or citrate-to-creatinine ratio is essential to ensure appropriate dosage of alkaline therapy.