Renal tubular acidosis, or RTA, refers to a group of disorders characterized by defective renal acid-base regulation. The capacity for normal urinary acidification is impaired, resulting in net acid retention and hyperchloremic metabolic acidosis. RTA is a rare disorder that tends to be over-diagnosed.
Listen to a pediatric nephrologist discuss renal tubular acidosis
In this episode, Danielle Soranno, MD reviews basic mechanisms of the disease that are important for diagnosis and management of RTA in your patients.
Dr. Soranno is an Associate Professor of Pediatrics, Bioengineering and Medicine at the University of Colorado School of Medicine and a pediatric nephrologist at Children’s Hospital Colorado.
In this episode, our expert discusses:
- What initially attracted her to nephrology and streamlined her career path in this direction
- The prevalence of RTA, overdiagnosis and the lab abnormality of low serum bicarb
- Doing a venous blood gas (VBG) test along with the basic metabolic panel (BMP)
- Determining the appropriate levels of serum creatinine for the patient’s age and size
- How to approach a low serum bicarb lab test, retesting and urine studies
- Failure to thrive as the main presenting factors and considerations for Fanconi syndrome
- Proximal RTA as a temporary condition that requires a large dose of sodium bicarb supplementation
- Distal RTA as a much rarer, often hereditary type and the process of evaluation
- Considerations for type 3 RTA and when the expertise of a nephrologist should be sought
- The importance of having the correct pH balance in the body
- Suggestions for how referring providers should talk to families about the diagnosis
- Important considerations for PCPs in terms of ongoing follow-up for patients
Kidney disease treatment at Children’s Colorado
The Kidney Center at Children's Colorado serves as a regional referral center for patients with kidney disease. We see several thousand patients each year and serve as the only pediatric dialysis center in Colorado. Children’s Colorado is ranked as one of the best hospitals in the nation for the treatment of pediatric kidney disorders by U.S. News and World Report.
Refer a patient to Children's Colorado.