Annals of Pediatric Endocrinology & Metabolism  2013;18(3):152-155

doi:10.6065/apem.2013.18.3.152

Refractory rickets caused by mild distal renal tubular acidosis.

Ji Ho LEE 1 ; Joo Hyun PARK ; Tae Sun HA ; Heon Seok HAN

Affiliations

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Keywords

Distal renal tubular acidosis; Rickets; Nephrocalcinosis

Country

Republic of Korea

Language

English

Abstract

Type I (distal) renal tubular acidosis (RTA) is a disorder associated with the failure to excrete hydrogen ions from the distal renal tubule. It is characterized by hyperchloremic metabolic acidosis, an abnormal increase in urine pH, reduced urinary excretion of ammonium and bicarbonate ions, and mild deterioration in renal function. Hypercalciuria is common in distal RTA because of bone resorption, which increases as a buffer against metabolic acidosis. This can result in intractable rickets. We describe a case of distal RTA with nephrocalcinosis during follow-up of rickets in a patient who presented with clinical manifestations of short stature, failure to thrive, recurrent vomiting, dehydration, and irritability.