What causes nephrocalcinosis and nephrolithiasis in patients with type 1 renal tubular acidosis (RTA)?

Updated: Dec 08, 2020
  • Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Patients with type 1 RTA may develop nephrocalcinosis and nephrolithiasis. This is thought to occur for the following reasons:

  • Patients have a constant release of calcium phosphate from bones to buffer the extracellular H+.

  • Patients have decreased reabsorption of calcium and phosphate, leading to hypercalciuria and hyperphosphaturia.

  • Patients have relatively alkaline urine, which promotes calcium phosphate precipitation.

  • Metabolic acidosis and hypokalemia lead to hypocitraturia, a risk factor for stones. Citrate in the urine complexes calcium and inhibits stone formation.

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