Symptoms of renal tubular acidosis?
summary
Renal tubular acidosis (RTA) is caused by the obstruction of the establishment of hydrogen ion (H +) gradient between the lumen and peritubular fluid of the distal renal tubule, or (and) the disturbance of the reabsorption of bicarbonate ions in the proximal renal tubule. Although some patients have renal tubular acidosis dysfunction, but there is no clinical manifestation of acidosis, it is called incomplete RTA. According to the lesion location and pathogenesis, RTA can be divided into proximal tubular RTA, hypokalemic distal tubular RTA and hyperkalemic distal tubular RTA. Now let's talk about the treatment of renal tubular acidosis.
Symptoms of renal tubular acidosis?
If the symptoms are serious or PCO2 > 8.0kpa (60mmhg) or the respiration is inhibited due to respiratory compensation (CO2 accumulation) resulting in hypoxia, acid drugs should be used. Can take ammonium chloride orally, if the patient cannot take it orally, can use ammonium chloride intravenous drip.
Supplement potassium salt, often oral potassium citrate. After taking citric acid mixture to prevent and treat renal calculi, renal calcification and bone diseases, urinary calcium will be mainly excreted in the form of calcium citrate with high solubility, which can prevent renal calculi and calcification. Calcium and calcitriol should be used carefully in patients with severe bone disease without renal calcification.
In order to correct acidosis, we should supplement alkali, and use citric acid mixture. This mixture can not only supplement alkali, but also reduce the formation of renal calculi and calcification. You can also take sodium bicarbonate.
matters needing attention
1. Hyperchloremic metabolic acidosis due to the obstruction of H + secreted by renal tubular epithelial cells into the lumen or the diffusion of H + in the lumen back to the periphery of the tube, the titratable acid and ammonium ion (NH -) in the urine of the patients decreased, and the urine could not be acidified to pH.
