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Medicine General 447d69b9

Which of the statements about Renal Tubular Acidosis type I (Type I A) is not true:

A
Failure to acidify urine to a pH < 5
B
Associated with increased risk of urinary stones
C
Associated with Hyperkalemia
D
Treatment involves alkali replacement as bicarbonate
High-Yield Explanation
Answer is C (Associated with Hyperkalemia) Type I A is associated with Hypokalemia and not Hyperkalemia. Type I and Type II A are both associated with hypokalemia. Hyperkalemia is a feature of Type IV Renal Tubular Acidosis. Type I A is associated with failure to acidify urine to a pH +( Minimum Urinary pH>5.5deg) Treatment of Type I (Distal) A involves alkali replacement with bicarbonate Early initiation of alkali replacement at doses equivalent 1-3 mmol/kg per day of bicarbonate in divided doses will usually correct the acidosis, hypokalemia and hypocitraturia maintaining growth and preventing bone disease in early onset dA. Citrate is generally tolerated better than sodium bicarbonate and can be given as the potassium or sodium salt depending on degree of hypokalemia.

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