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Renal Tubular Acidosis: Diagnosis and Management

Cheryl Whitten
Cheryl Whitten
April 25, 2024
•
4
min read
Medically reviewed by:
Trager Hintze, PharmD
Renal Tubular Acidosis: Diagnosis and Management
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Renal tubular acidosis is a group of disorders that cause acid and electrolyte problems. The condition may progress to chronic kidney disease or cause complications if left untreated [1]. Here’s what you need to know about renal tubular acidosis.

What Is Renal Tubular Acidosis?

Renal tubular acidosis (RTA) is a serious kidney disease that happens when the filtration tubes of your kidneys become damaged. These damaged tubules either don’t remove enough acids from the blood into your urine or remove too much base, leading to high blood acid [2]. 

Your body keeps an acid-base balance within a tight range [3]. A high acid level in the blood, or acidosis, disturbs electrolytes and causes heart, muscle, and nerve problems [2].

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The pH scale: A pH of 7.0 is neutral; values below 7 are acidic, while those above 7 are alkaline.

Types of Renal Tubular Acidosis

RTA may be an inherited disease that starts in childhood or may develop from time to time because of other conditions like diabetes or autoimmune diseases [4]. 

There are four types of RTA, which include [5]:

  • Type 1 or distal RTA: occurs when there's damage at the end of the tubules 
  • Type 2 or proximal RTA: the damage is at the beginning of the tubules
  • Type 3 or mixed RTA: a combination of type 1 and type 2
  • Type 4 or hyperkalemic RTA: the tubules cannot remove enough potassium, interfering with acid removal

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Type 1 leads to kidney stones and may cause further damage or chronic kidney disease [6]. Type 2 causes bone pain, rickets in children, and osteomalacia in adults, and type 4 may cause muscle paralysis and irregular heart rhythms [1].

Diagnosis

Your doctor diagnoses RTA with blood and urine tests to measure specific markers. Urine tests may include a urinalysis using pH test strips to measure urine acidity, a urine culture to rule out bacteria and infection, and a urine anion gap test to measure ions [4].

Treatment

The treatment for RTA is to drink a sodium bicarbonate or potassium bicarbonate solution. Potassium bicarbonate is necessary for those who have low potassium levels. [6] Some people must take sodium bicarbonate or baking soda every day to control chronic acidosis [6]. Your doctor can also treat underlying conditions that may be causing RTA. 

While bananas and spinach are able to provide potassium bicarbonate, they are not enough to replace potassium bicarbonate for treating renal tubular acidosis, which needs careful medical management.
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What Are the Symptoms of Unbalanced pH Levels?

You don’t always know you have unbalanced pH levels, but symptoms may appear suddenly. The major signs are low potassium and bicarbonate in your blood 950.

Common symptoms include [2]:

  • Extreme tiredness and weakness
  • Muscle twitching and cramps
  • Irregular heartbeat
  • Kidney stones
  • Chest pain
  • Nausea or vomiting
  • Diarrhea

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RTA with low potassium is a serious condition and can lead to death if it goes untreated. [5] Uncontrolled or untreated RTA can also lead to complications, including [5]:

  • Slow growth in children
  • Rickets and bone disease
  • Dental problems
  • Kidney failure
  • Cardiac arrest

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Using Urinalysis Tests or Urine pH Test Strips

The Diagnox pH Test is a multipurpose at-home test that can measure pH levels in urine or saliva.

Home pH tests or urine pH test strips are a simple way to monitor your health, efficacy of treatment, and acid-base balance [7]. Urine pH normally measures between 5 and 6, and urine test strips that show a urine pH above or below these numbers may mean problems with your kidneys [8] .

However, you need other tests to confirm RTA and acidosis problems. If you have symptoms of RTA or think your urine is too acidic or alkaline, talk to your doctor. 

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Monitor Your Urinary Health With Diagnox

Regular health screening is part of living with chronic conditions, such as renal tubular acidosis. Diagnox's Urinox-10 urine test strips and the pH test strips are FDA-approved and CLIA-waived tests for accurate diagnosis and easy monitoring of urine pH, kidney function, and other parameters. Stay on top of your health and feel confident with Diagnox. Buy your strips. 

References

[1] L. A. Hechanova, “Renal Tubular Acidosis,” Merck Manual Professional Version, 2022. [Accessed April 22, 2024].

[2] Tampa General Hospital Staff, “Acidosis.” [Accessed April 22, 2024].

[3] E. Hopkins, T. Sanvictores and S. Sharma, “Physiology, Acid Base Balance,” StatPearls, 2024. [Accessed April 24, 2024].

[4] R. Mustaqeem and A. Arif, “Renal Tubular Acidosis,” StatPearls, 2024. [Accessed April 22, 2024]. 

[5] National Institute of Diabetes and Digestive and Kidney Diseases Staff, “Renal Tubular Acidosis,.” [Accessed April 22, 2024].

[6] L. A. Hechanova, “Renal Tubular Acidosis (RTA),” Merck Manual Consumer Version, 2022. [Accessed April 22, 2024].

[7] Informed Health Staff, “Understanding Urine Tests,” Informed Health.org. [Accessed April 22, 2024].

[8] J. Yaxley and C. Pirrone, “Review of the Diagnostic Evaluation of Renal Tubular Acidosis,” Ochsner Journal, 2016. [Accessed April 22, 2024].

About the Author
Cheryl Whitten

Cheryl Whitten is a health writer with a background in allied health care as an herbalist and clinical aromatherapist. She holds a Bachelor of Arts in English literature from Athabasca University and certificates from the University of Maryland and Wild Rose College. She writes for leading health and lifestyle websites with a focus on health, wellness, and consumer products.

About the Reviewer
This blog was
Medically reviewed by:
Trager Hintze, PharmD

Trager Hintze is a clinical assistant professor and emergency medicine clinical pharmacist located in College Station, Texas. He has a bachelor's degree in biology as well as a Doctor of Pharmacy degree. He balances teaching at Texas A&M University College of Pharmacy and practicing emergency medicine at St. Joseph Regional Health Hospital.

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