Journal
INTERNAL MEDICINE
Volume 54, Issue 7, Pages 725-730Publisher
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.54.9421
Keywords
primary distal renal tubular acidosis; hypokalemia; kidney stones
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Funding
- National Basic Research Program of China 973 Program [2012CB517600, 2012CB517604]
- National Natural Science Foundation of China [81070560, 81070568]
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Objective Distal renal tubular acidosis (dRTA) is a hyperchloremic metabolic acidosis disorder characterized by a normal anion gap with abnormal urinary hydrogen (H+) excretion. At present, there are few available reports regarding the clinical status of primary dRTA. The primary objective of this study was to analyze the clinical features and outcomes of primary dRTA. Methods This was a retrospective study performed in patients with primary dRTA who were hospitalized at Ruijin Hospital between March 1996 and July 2009; the clinical features of these patients were analyzed. Results This study included 95 consecutive inpatients: 40 men (42.11%) and 55 women (57.89%). Among them, 60 had hypokalemia (63.12%), 29 had complete dRTA and 66 had incomplete dRTA. The mean urine calcium levels of the patients with and without urinary lithiasis were 0.10 +/- 0.04 and 0.07 +/- 0.05 mmol/24 h center dot kg, respectively (p=0.04). The blood pH values of the patients with and those without bone disease were 7.37 +/- 0.06 and 7.32 +/- 0.06, respectively (p=0.01). A total of 8.33% (8/27) of the patients had tubular proteinuria. Conclusion Hypokalemia is the most common clinical manifestation of primary dRTA. Primary dRTA can also be accompanied by proximal tubular dysfunction. Controlling the urine calcium and citrate levels is crucial for the treatment of nephrocalcinosis and/or nephrolithiasis, while restoring the blood pH to the normal level is essential for controlling bone disease.
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