When should type 1 renal tubular acidosis (RTA) be suspected in patients with non-anion gap (AG) (hyperchloremic) metabolic acidosis?

Updated: Oct 10, 2018
  • Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Type 1 RTA should be suspected in any patient with non-AG metabolic acidosis and a urine pH greater than 5.0. Patients have a reduction in serum HCO3- to various degrees, in some cases to less than 10 mEq/L. They are able to reabsorb HCO3- normally, and their FE of HCO3- is less than 3%. The disorder has been classified into 4 types—secretory, rate dependent, gradient, and voltage dependent—based on the nature of the defect.


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