OVERVIEW
OVERVIEW
Type I renal tubular acidosis is a type of renal tubular acidosis, which occurs when distal renal tubules are dysfunctional and fail to acidify the urine normally, with decreased urinary ammonium and titratable acid excretion. Clinical features are hyperchlorhydria metabolic acidosis, hypokalemia, and inability to acidify the urine.
Whether medical insurance
yes
Department
Nephrology
Synonyms
Distal renal tubular acidosis, Hypokalemic distal renal tubular acidosis
Clinical Symptoms
Anorexia, nausea, vomiting, diarrhea, constipation and other clinical symptoms.
Hazards
The disease may progress to chronic renal failure, leading to death.
Complications
Electrolyte disorders, kidney stones, renal bone disease, acute renal insufficiency, chronic renal insufficiency, nephrogenic uremic syndrome.
Examination
Blood biochemistry test, urine routine, urine biochemistry test, ammonium chloride loading test, urine PCO2/blood PCO2, X-ray and ultrasound examination of urinary system.
Diagnosis
Diagnosis can be made on the basis of the presence of hyperchloremic metabolic acidosis with normal anion gap (AG), hypokalemia, reduction of titratable acid or/and NH4+ in the urine by laboratory tests, and a urinary pH > 6.0.
Treatment principle
Clinical treatment is mainly based on correcting the etiology and symptomatic treatment.
Curability
Symptoms may improve after treatment.
Dietary recommendations
Low salt and low fat, high quality protein diet.
Etiology
Epidemiology
The disease is most common in young and middle-aged people and is more prevalent in women.
Etiology
The disease is caused by acidification dysfunction of the distal renal tubules, and can be caused by genetic factors or other diseases.
Symptoms and Diagnosis
Typical symptoms
1. Children may have growth retardation and neurological deafness. 2. AG normal hyperchloremic metabolic acidosis: manifested by anorexia, nausea, vomiting, diarrhea, constipation; 3. Electrolytic disorders: patients may have generalized muscular weakness and periodic paralysis. 4. Urinary tract symptoms: there may be hematuria, dysuria and other manifestations. 5. Impaired renal concentrative function, with symptoms of polydrinking, polyuria, and irritable thirst being common. 6.
Diagnostic basis
1. Clinical symptoms such as anorexia, nausea, vomiting, diarrhea, constipation, etc. are mostly manifested. 2. Hyperchloremic metabolic acidosis and hypokalemia with AG normal are present. 3. Combined with laboratory aids such as reduction of titratable acid or/and NH4+ in the urine and urinary pH>6.0, etc., the diagnosis can be made.
Treatment
Treatment guidelines
1. Correct acidosis; 2. Supplement potassium; 3. Prevent kidney stones, renal calcification and bone disease.
Drug treatment
1. Citrate combination or sodium bicarbonate can be taken to correct acidosis. 2. Oral potassium citrate can be taken to replenish blood potassium. 3. Calcium and osteotriol can be applied to prevent stones and calcification.
Prognosis
The prognosis is good for those who are detected early, treated early, and do not develop renal calcification and skeletal deformity.
Nursing care
Daily care
1. Keep calm and avoid aggravation of the condition by bad emotion. 2. Pay attention to the combination of work and rest, avoid overwork, choose suitable exercise to improve the resistance of the body. 3. Regularly review the condition, and consult the doctor in time when there is any change in the condition. 4.
Diet
Provide enough high-calorie, vitamin-rich, easy-to-digest diet, and appropriately regulate the proportion of high sugar and lipids in the dietary calories, so as to reduce the decomposition of autologous proteins and alleviate the burden on the kidneys.