Pediatric total distal tubular acidosis

Renal tubular acidosis (RTA) is a clinical syndrome caused by the reabsorption of bicarbonate in the proximal tubule or a defect in the function of hydrogen excretion in the distal tubule. According to the damaged tubules and their pathophysiology, they are divided into 4 types: Type Ⅰ is distal renal tubular acidosis (dRTA), also known as classic renal tubular acidosis. Type Ⅱ is proximal renal tubular acidosis (pRTA). Type Ⅲ is a mixture of type Ⅰ and type Ⅱ, also known as mixed type. Type IV renal tubular acidosis is due to metabolic poisoning and hyperkalemia caused by congenital or acquired insufficient aldosterone secretion or insensitive tubular response to aldosterone. The cause of each type can be divided into primary or secondary renal tubular acidosis. Generalized distal renal tubular acidosis, also known as hyperkalemic renal tubular acidosis, is caused by insufficient aldosterone secretion or poor response to renal tubules. Metabolic acidosis and persistent hyperkalemia. Although there is metabolic acidosis, the difference between dRTA and urine can be acidic, and the difference between pRTA and urine is that HCO3- is lower.