Renal tubular acidosis causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2] Jogeet Singh Sekhon, M.D. [3] Syed Ahsan Hussain, M.D.[4]

Ovevriew

Primary causes of renal tubular acidosis include genetic mutations causing defects in the kidney anion exchanger [kAE1] in distal tubule intercalated cells and congenital adrenal hyperplasia. Secondary causes include medications and autoimmune diseases.

Causes

The following table summarizes the common primary and secondary causes of renal tubular acidosis.^[1]^[2]^[3]

	Primary Causes	Secondary Causes
Type 1	Idiopathic Familial Autosomal dominant Mainly due to mutations causing defects in the kidney anion exchanger [kAE1] in distal tubule intercalated cells. Autosomal recessive Mainly due to mutations causing defects in V-ATPase in distal tubule intercalated cells.	Autoimmune disorders Medications Ifosfamide Amphotericin B Lithium carbonate Ibuprofen Hypercalciuric conditions Hyperparathyroidism Vitamin D intoxication Sarcoidosis Idiopathic hypercalciuria Others
Type 2	Recessive Proximal tubule cell sodium bicarbonate co-transporter (NBCe1) defect Carbonic anhydrase type 2 deficiency Cystinosis Tyrosinemia Hereditary fructose intolerance Galactosemia Glycogen storage disease (type I) Lowe syndrome	M-protein disorders Amyloidosis Multiple myeloma Medications Ifosfamide Tenofovir Acetazolamide Topiramate Aminoglycosides Heavy metals Lead Cadmium Mercury Copper Other Medullary sponge kidney Obstructive uropathy Renal transplant rejection Wilson disease
Type 4	Congenital hypoaldosteronism 21-hydroxylase deficiency Isolated hypoaldosteronism Pseudohypoaldosteronism type 2 Primary adrenal insufficiency Pseudohypoaldosteronism type 1	Angiotensin inhibitors, such as ACE inhibitors Angiotensin II receptor blockers Direct renin inhibitors Antibiotics, trimethoprim, and pentamidine Potassium-sparing diuretics Spironolactone Eplerenone Amiloride Triamterene

References

↑ Haque SK, Ariceta G, Batlle D (December 2012). “Proximal renal tubular acidosis: a not so rare disorder of multiple etiologies”. Nephrol. Dial. Transplant. 27 (12): 4273–87. doi:10.1093/ndt/gfs493. PMC 3616759. PMID 23235953.
↑ Batlle D, Haque SK (October 2012). “Genetic causes and mechanisms of distal renal tubular acidosis”. Nephrol. Dial. Transplant. 27 (10): 3691–704. doi:10.1093/ndt/gfs442. PMID 23114896.
↑ Alper SL (2010). “Familial renal tubular acidosis”. J. Nephrol. 23 Suppl 16: S57–76. PMID 21170890.

[pmid23235953-1] Haque SK, Ariceta G, Batlle D (December 2012). “Proximal renal tubular acidosis: a not so rare disorder of multiple etiologies”. Nephrol. Dial. Transplant. 27 (12): 4273–87. doi:10.1093/ndt/gfs493. PMC 3616759. PMID 23235953.

[pmid23114896-2] Batlle D, Haque SK (October 2012). “Genetic causes and mechanisms of distal renal tubular acidosis”. Nephrol. Dial. Transplant. 27 (10): 3691–704. doi:10.1093/ndt/gfs442. PMID 23114896.

[pmid21170890-3] Alper SL (2010). “Familial renal tubular acidosis”. J. Nephrol. 23 Suppl 16: S57–76. PMID 21170890.

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