Renal tubular acidosis

ABSTRACT

The clinical laboratory and X-Ray findings of 16 patients with distal [type-1] renal tubular acidosis diagnosed at Mayo and Sheikh Zayed Hospital, Lahore during an eight year period [1984 to 1992] are presented. Twelve patients [75%] were males and four females [25%]. Their ages ranged between 1.5 and 41 years [mean age 12.8 years]. Eight patients [50%] had radiologically evident bone disease in the form of rickets or osteomalacia. Two patients had pathological fractures. Growth retardation was noted in 10 patients [63%]. Polyuria and polydipsia were noted in 6 patients [31%]. Nephrocalcinosis and or nephrolithiasis was evident in 12 patients [75%]. Muscle weakness were noted in 7 patients [44%]. Biochemical derangements observed were hyperchloremic metabolic acidosis mean blood pH = 7.259 +/- 0.055, but urine pH remained alkaline in all patients during all grades of metabolic acidosis with a mean value of 6.69 [range 5.8 to 8.0]. Serum Chloride level was mean 111 +/- 5.288 mmol/l. Hypocalcemia, hyponatremia and hypokalemia was noted with mean values of 8.44 +/- 1.24 mg/dl, 134 +/- 3.56 mmol/l and 3.68 +/- 0.53. Treatment with alkali therapy resulted in general well being, reduced bone pains, muscle weakness and improved growth significantly