From previous post……
RENAL TUBULAR ACIDOSIS TYPE II
RTA type II is also known as proximal RTA, it is due to failure of proximal tubule to re-absorb HCO3. It is less common than RTA type I . It is most commonly occurs as part of generalized proximal tubular defect that results in glycosuria, aminoaciduria, phosphaturia and renal tubular acidoisis- the Fanconi syndrome.
Causes of proximal RTA can be due to congenital or acquired causes.
Congenital causes are Hereditary, Wilson’s disease, Cystinosis and fructose intolerance.
Acquired causes are autoimmune disease ( such as Sjogren’s), drugs ( lead, tetracycline), myeloma, amyloid, hyperparathyroidism and nephrotic syndrome.
PROXIMAL- hyperParathyroidism, Renal ( nephrotic syndrome, interstitial nephritis), OX ( others- drugs- tetracycline), I ( autoimmune) ,Myeloma, Amyloid and Lead!
A few important points to remember,
1)calculus formation is uncommon in proximal RTA and
2)plasma HCO3 tens to be higher!
RTA type III
Combination of type I and II- very rare, seldom asked in MRCP
RENAL TUBULAR ACIDOSIS TYPE IV
The commonest type of RTA. Patients are acidotic and HYPERKALEMIA!
It is known as hyporeninaemic hypoaldosteronism. It is common associated with diabetic nephropathy. The defect is caused either by hypoaldosteronism or renal resistance to the effect of aldosterone!
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