Diversity of initial manifestations in renal tubular acidosis.
- Author:
Hye Ryun CHANG
1
;
Jay Wook LEE
;
Nam Ju HEO
;
Jung Hwan PARK
;
Dong Jun PARK
;
Eun Young SEONG
;
Kwon Wook JOO
;
Yeon Su KIM
;
Cu Rie AHN
;
Jin Suk HAN
;
Suhng Gwon KIM
;
Jung Sang LEE
Author Information
1. Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea. jshan@snu.ac.kr
- Publication Type:Original Article
- Keywords:
RTA;
Manifestations
- MeSH:
Acidosis;
Acidosis, Renal Tubular*;
Asthenia;
Diabetic Nephropathies;
Diagnosis;
Female;
Follow-Up Studies;
Humans;
Hypokalemia;
Lower Extremity;
Male;
Medical Records;
Medullary Sponge Kidney;
Nausea;
Paralysis;
Paresthesia;
Potassium;
Retrospective Studies;
Sjogren's Syndrome;
Urinary Calculi
- From:Korean Journal of Medicine
2004;66(2):167-174
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Diagnosis of RTA (renal tubular acidosis) is not easy due to its nonspecific and various manifestations. To find out the clues to diagnosis, we investigated initial manifestations, laboratory features and clinical course of RTA patients. METHODS: Thirty-seven patients with RTA type I or II, whose follow-up period was over 6 months were included in the study. We reviewed their medical records retrospectively. RESULTS: Male to female ratio was 5:32 and the average age at the time of diagnosis was 38.7 (15~60). Twenty-five patients had RTA type I, nine had type II, and three had both. The average follow-up period was 6.4 years. Initial manifestations were asthenia (54%), nausea (46%), urinary stone (24%), paresthesia (24%), lower extremity weakness (22%), and paralysis (11%). Underlying diseases at the time of diagnosis include Sjogren's syndrome (14%), SLE (8%), drug-induced nephropathy (11%), diabetic nephropathy (5.4%), Sjogren's syndrome combined with SLE (2.7%), and medullary sponge kidney (2.7%). Laboratory tests revealed acidosis with hypokalemia (59%), acidosis without hypokalemia (14%), and hypokalemia without acidosis (24%). The level of total CO2 was 22 mmol/L or lower in 27 patients. The Na:Cl ratio on the average was 1:1.26 and for 33 patients below 1:1.35. Renal function deteriorated in 8 patients and 7 of them had underlying diseases. Urinary stone developed in 2 patients with RTA type I. CONCLUSION: When patients with nonspecific symptoms show decreased levels of serum total CO2, potassium, or Na:Cl ratio, RTA should always be considered.
