Overview
What Renal Tubular Acidosis Is and Why Potassium Comes First
Renal tubular acidosis (RTA) is a group of disorders in which the kidney tubules cannot appropriately maintain acid base balance.
NCLEX-RN
NCLEX-RN
Renal tubular acidosis (RTA) is a group of disorders in which the kidney tubules cannot appropriately maintain acid-base balance. The filter may be working well. The problem sits downstream, in the tubules that are supposed to reclaim bicarbonate and get rid of acid. That is why RTA typically produces a normal-anion-gap metabolic acidosis, often with a relatively preserved glomerular filtration rate. RTA is primarily a tubular acid-base disorder. It differs from metabolic acidosis caused by advanced kidney failure, lactic acidosis or ketoacidosis, where an added or retained acid is the main story. Picture a patient who has had kidney stones for years and now cannot climb the stairs because her legs feel heavy. The blood gas is abnormal, but that is not what could stop her heart or her breathing tonight. Her potassium could. Hold on to this idea before anything else: potassium disturbances may pose a more immediate danger than the chronic acid-base disorder itself. Types 1 and 2 waste potassium, and type 4 retains it. Both directions can cause lethal dysrhythmia, and both can cause muscle weakness. The...
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