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Topic: Renal tubular acidosis, distal, type 4

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	Renal Tubular Acidosis (Site not responding. Last check: 2007-10-29)
		Renal tubular acidosis (RTA) is a disease that occurs when the kidneys fail to excrete acids into the urine, which causes a person's blood to remain too acidic.
		Type 4 RTA is caused by another defect in the distal tubule, but it is different from classic distal RTA and proximal RTA because it results in high levels of potassium in the blood instead of low levels.
		Type 4 RTA is distinguished by a high blood-potassium level.
	kidney.niddk.nih.gov /kudiseases/pubs/tubularacidosis/index.htm (1446 words)

	s051114a - Distal Renal Tubular Acidosis
		Renal dysfunction in renal tubular acidosis is not always confined to acid excretion and can be part of a more generalised renal tubule defect, as in the renal Fanconi syndrome.
		The importance of plasma potassium and renal potassium excretion in the evaluation of patients with distal renal tubular acidosis is emphasized.
		In the presently studied patients, the impairment in renal conservation of sodium appeared to be in part the consequence of an impaired ability of the vasopressin-responsive segments of the distal nephron to generate and maintain appropriately steep transepithelial sodium concentration gradients.
	www.emory.edu /WHSCL/grady/amreport/litsrch05/s051114a.html (3774 words)

	Dorlands Medical Dictionary
		renal tubular acidosis without the usual lowering of the pH of urine in the distal tubules; a nonhereditary type seen in infant boys is called Lightwood syndrome, and an autosomal dominant type seen later in life is called Butler-Albright syndrome.
		renal tubular acidosis caused by malfunction of the proximal tubules.
		acidosis due to excess retention of carbon dioxide in the body, as opposed to metabolic acidosis; it is seen in chronic obstructive pulmonary disease and other conditions that interfere with normal ventilation.
	www.mercksource.com /pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSzdmd_a_08zPzhtm (1798 words)

	MedFriendly.com: Renal tubular acidosis
		Renal tubular acidosis (abbreviated RTA) is a syndrome in which the kidney tubules (see next section) are not able to adequately remove acids from the blood and release them into the urine.
		DISTAL RTA (also known as Type 1 RTA and classic RTA): The main problem in distal RTA is that the distal tubules cannot excrete enough acid (in the form of hydrogen ions) from the blood into the urine.
		Renal sodium wasting is common in distal RTA and leads to an increased loss of potassium in the urine and hyperaldosteronism.
	www.medfriendly.com /renaltubularacidosis.html (7181 words)

	8.5 Renal Tubular Acidosis
		Acidosis due to renal disease is considered in 2 categories depending on whether the predominant site of renal damage is in the gloweruli or in the tubules.
		Renal tubular acidosis is a form of hyperchloraemic metabolic acidosis which occurs when the renal damage primarily affects tubular function without much effect on glomerular function.
		Type 3 RTA is now considered a subtype of Type 1 where there is a proximal bicarbonate leak in addition to a distal acidification defect.
	www.anaesthesiamcq.com /AcidBaseBook/ab8_5.php (919 words)

	Renal tubular acidosis
		Renal tubular acidosis (RTA) is a condition characterized by too much acid in the body due to a defect in kidney function.
		Distal renal tubular acidosis (type 1) may be a hereditary condition or may be triggered by an autoimmune disease, lithium therapy, kidney transplantation, or chronic obstruction.
		Type 4 RTA is characterized by high blood acidity and high blood potassium levels; it rarely causes symptoms unless potassium levels rise so high as to cause heart arrhythmias or muscle paralysis.
	www.lifesteps.com /gm/Atoz/ency/renal_tubular_acidosis.jsp (798 words)

	Renal Tubular Acidosis
		Renal tubular acidosis is a condition or disease in which the kidney does not take acid out of blood and put it into urine like it should.
		Type III was formerly type I with a component of type II, and now that is just called type I. Some infants and small children with type I RTA also lose some bicarbonate into the urine at the level of the proximal tubule.
		Acidosis can also result from overproduction of acid, and the kidney can be working fine and getting rid of acid very well, but the amount produced can overwhelm the ability of the kidney to get rid of it.
	cnserver0.nkf.med.ualberta.ca /nephkids/rta.htm (1768 words)

	Renal Tubular Acidosis: The Clinical Entity -- Rodríguez Soriano 13 (8): 2160 -- Journal of the American Society ...
		Proximal RTA (type 2) is caused by an impairment of HCO
		in the proximal tubule and is characterized by a decreased renal
		all indicative of the coexistence of proximal and distal RTA
	jasn.asnjournals.org /cgi/content/full/13/8/2160 (5326 words)

	Information about renal tubular acidosis
		Renal tubular acidosis is a disease that occurs when the kidneys fail to excrete acids into the urine, which causes a person's blood to remain too acidic.
		Type 4 renal tubular acidosis is caused by another defect in the distal tubule, but it is different from classic distal renal tubular acidosis and proximal renal tubular acidosis because it results in high levels of potassium in the blood instead of low levels.
		To treat type 4 renal tubular acidosis successfully, patients may require alkaline agents to correct acidosis as well as medication to lower the potassium in their blood.
	www.mamashealth.com /kidney/rta.asp (1066 words)

	Distal renal tubular acidosis
		Distal renal tubular acidosis is caused by abnormal excretion of acid from the distal tubule of each nephron.
		Distal renal tubular acidosis (Type I RTA) is a disorder caused by a defect in the secretion of hydrogen ions in the distal renal tubule of each nephron.
		Renal tubular acidosis causes disorders related to the loss of bicarbonate and inability to excrete hydrogen.
	www.baylorhealth.com /HealthInformation/1/000493.htm (467 words)

	RENAL TUBULAR ACIDOSIS RTA PEDIATRIC ONCALL (Site not responding. Last check: 2007-10-29)
		Renal tubular acidosis (RTA) is one of the commonest causes of Vit D resistant rickets.
		RTA is a group of disorders in which there is metabolic acidosis due to defect in renal tubular acidification mechanism to maintain normal plasma bicarbonate and blood pH.
		Reabsorption of sodium bicarbonate (alkali) by proximal renal tubules.
	www.pediatriconcall.com /fordoctor/diseasesandcondition/renal_tubulardoc.asp (991 words)

	eMedicine - Hyperchloremic Acidosis : Article by Mahendra Agraharkar, MD, FACP
		A normal AG acidosis is characterized by a lowered bicarbonate concentration, which (in the presence of a normal sodium concentration) is counterbalanced by an equivalent increase in plasma chloride concentration.
		A metabolic acidosis occurring secondary to decreased renal acid secretion in the absence of marked decreases in the glomerular filtration rate and characterized by a normal AG is due to diseases that are usually grouped under the term dRTA.
		Depending on the type of RTA, the goals of therapy are to decrease the rate of progressive renal insufficiency by preventing nephrocalcinosis and nephrolithiasis; to neutralize metabolic bone disease; and, in children, to improve growth.
	www.emedicine.com /med/topic1071.htm (6582 words)

	UpToDate Pathophysiology of renal tubular acidosis and the effect on potassium balance
		Type 4 RTA or hypoaldosteronism is associated with hyperkalemia and a mild metabolic acidosis (show table 4)
		— Type 2 RTA is characterized by a decrease in proximal bicarbonate reabsorptive capacity, resulting in a fall in the plasma bicarbonate concentration.
		As examples, inherited defects in the gene for the sodium bicarbonate cotransporter results in autosomal recessive type 2 RTA (with concurrent ocular abnormalities) [7], while mutations in the gene for a plasma membrane sodium hydrogen exchanger may be responsible for autosomal dominant disease [8].
	patients.uptodate.com /print.asp?print=true&file=fldlytes/22261 (687 words)

	Renal Tubular Acidosis: NIDDK - WrongDiagnosis.com - WrongDiagnosis.com
		Conditions: Renal Tubular Acidosis, Type 1 RTA, Type 2 RTA, Type 4 RTA
		One researcher has theorized that Charles Dickens may have been describing a child with RTA when he created the character of Tiny Tim in his famous story, "A Christmas Carol." Tiny Tim's small stature, malformed limbs, and periods of weakness are all possible consequences of the chemical imbalance caused by RTA.
		Type 3 is rarely used as a classification because it is now thought to be a combination of type 1 and type 2.
	www.wrongdiagnosis.com /artic/renal_tubular_acidosis_niddk_printer.htm (1479 words)

	HDCN: ASN abstract by Schwarz et al. Renal tubular acidosis in kidney transplant recipients. JASN 11 2005
		Renal tubular acidosis was diagnosed in 13% of the transplant recipients.
		RTA type 4 was present in 28% but no one of the patients showed RTA type 2 (proximal).
		The main forms of posttransplant RTA are type 1(distal) and type 4 (hyperkalaemic).
	www.hdcn.com /a5/05ffc025.htm (593 words)

	Renal Tubular Acidosis
		Loss of tubular function affects the ability of the kidney to excrete hydrogen ions and retain bicarb, this will lead to non-gap acidoses.
		When the tubules fail without loss of glomerular function, bicarb is lost and instead of being replaced by phosphates, sulfates, and urea it is replaced by chloride leading to hyperchloremic, non anion gap metabolic acidoses, the sine qua non of RTA’s.
		In the distal tubule the remaining 20-30% of bicarb is reabsorbed in the same way.
	home.uchicago.edu /~adamcifu/RTA.htm (442 words)

	Renal tubular acidosis - MayoClinic.com (Site not responding. Last check: 2007-10-29)
		Renal tubular acidosis (RTA) is a condition in which your kidneys are unable to excrete acids into urine.
		In renal tubular acidosis, the ability of your kidneys to excrete acids or to reabsorb bicarbonate is impaired, and acid levels build up in your blood.
		Type 4 is the only type that is not hereditary.
	www.mayoclinic.com /health/renal-tubular-acidosis/AN00642 (448 words)

	eMedicine - Metabolic Acidosis : Article by Karen L Stavile, MD
		Metabolic acidosis with a high AG is associated with the addition of endogenously- or exogenously-generated acids.
		Since metabolic acidosis is a condition that occurs in response to a variety of disease states, the prognosis is directly related to the underlying etiology and the ability to treat or correct that particular disorder.
		Kurtzman NA: Renal tubular acidosis: a constellation of syndromes.
	www.emedicine.com /emerg/topic312.htm (3498 words)

	renal tubular acidosis type IV - General Practice Notebook (Site not responding. Last check: 2007-10-29)
		renal tubular acidosis type IV Type 4 renal tubular acidosis occurs in diseases and conditions associated with a failure of aldosterone action or hypoaldosteronism.
		In this type of renal tubular acidosis, the acidosis is a result of loss of pH regulation secondary to hyperkalaemia.
		The pH of the urine is usually below 5.4, and there is hyperkalaemia, secondary to hypoaldosteronism - mineralocorticoid deficiency causes a reduction in secretion of H+ in the distal nephron and a reduction in NH4+ sectretion.
	www.gpnotebook.co.uk /cache/463077421.htm (166 words)

	Toxicity
		It is evidenced by dysentery, tenesmus, ulceration of the colonic mucosa, and hemorrhage.
		However, the acute symptoms assoc with irritation of the GI system and renal failure caused by inorganic mercury compounds are seldom observed in poisoning by alkyl mercury compounds and then almost exclusively in acute poisoning.
		Measurement of retinal binding protein appears to be a better marker for early tubular dysfunction due to its stability in the urine subsequent to collection and analysis.
	www.nomercury.org /atsdr.htm (8995 words)

	Search Tuna Report for uremia (Site not responding. Last check: 2007-10-29)
		Background: Uremia is a syndrome of clinical and metabolic abnormalities associated with fluid, electrolyte, and hormone imbalances, which develop in parallel with deterioration of renal function.
		In general, uremia is associated with chronic renal failure CRF, but it also may occur with acute renal failure ARF if loss of renal function is rapid.
		Chronic renal Failure CRF Is Diagnosed By The Observation Of A Combination Of Symptoms And Elevated Blood Urea Nitrogen BUN And Creatinine Cr Levels....
	www.searchtuna.com /ftlive2/2962.html (1634 words)

	Renal Tubular Acidosis Discussion
		Renal Tubular Acidosis is a scary diagnosis for any parent who hears it, but once understood, with support, ideas and help from other parents, it can make the road less worrisome.
		Types of RTA: Type 1: Classic Distal RTA
		This disorder may be inherited as a primary disorder or may be one symptom of a disease that affects many parts of the body.
	aaaaq.com /kidney_urologic/Renal_Tubular_Acidosis (1671 words)

	MedlinePlus Medical Encyclopedia: Urinalysis
		It consist of a battery of chemical and microscopic tests to screen for urinary tract infections, renal (kidney) disease, and diseases of other organs that result in the appearance of abnormal metabolites (break-down products) in the urine.
		There are several types of reagent strips, and it depends on the type of strip as to what tests can be performed.
		There may be times when the acidic urine may help prevent some kinds of kidney stones and may prevent growth of certain types of bacteria.
	www.nlm.nih.gov /medlineplus/ency/article/003579.htm (1253 words)

	naturopathy
		Epstein CJ, 2001Genetic modification of prenatal lethality and dilated cardiomyopathy in Mn superoxide dismutase mutant mice.
		Grice AS, Peck TE 2001 Multiple acyl-CoA dehydrogenase deficiency: a rare cause of acidosis with an increased anion gap.
		Philippi H, Boor R, Reitter B. 7 Topiramate and metabolic acidosis in infants and toddlers.
	www.anma.com /monref72.html (673 words)

	Physiology, UCL
		Parrington,J., Brind,S., De Smedt,H., Gangeswaran,R., Lai,A.F., Wojcikiewicz,R., Carroll,J. Expression of inositol 1,4,5-trisphosphate receptors in mouse oocytes and early embryos: the type I isoform is upregulated in oocytes and downregulated after fertilization.
		Pell,T.J., Baxter,G.F., Yellon,D.M., Drew,G.M. Adenosine receptors and KATP channels are involved in renal preconditioning of the myocardium.
		Sewell,K.J., Shirley,D.G., Michael,A.E., Thompson,A., Norgate,D.P., Unwin,R.J. In vivo inhibition of renal 11β-hydroxsteroid dehydrogenase by carbenoxolone in the rat and its relationship to sodium excretion.
	www.physiol.ucl.ac.uk /publications/index.php?years=pre2000 (5977 words)

	Metabolic acidosis without anion gap > 14-16 (Site not responding. Last check: 2007-10-29)
		or nephrolithiasis, and hyperchloremic metabolic acidosis with normal anion gap.
		Screening test with the second voided morning urine following an overnight fast and ingestion of a small water load.
		A urine pH < 6 is good evidence against distal RTA.
	enotes.tripod.com /metacid2.htm (147 words)

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