Distal renal tubular acidosis is a disease that occurs when the kidneys don't remove acid properly into the urine, leaving the blood too acidic (called acidosis).

Your kidneys normally regulate your body's pH by controlling acids.

Distal renal tubular acidosis (Type I RTA) is caused by a defect in the kidney tubes that causes acid to build up in the bloodstream.

Type I RTA is caused by a variety of conditions, including:

• Autoimmune diseases
• Drugs such as amphotericin B, lithium, and analgesics
• Hereditary disorders

• Confusion or decreased alertness
• Fatigue
• Impaired growth
• Increased breathing rate
• Kidney stones
• Nephrocalcinosis
• Osteomalacia
• Rickets
• Skeletal deformities
• Muscle weakness

Other symptoms can include:

• Bone pain
• Bloody urine
• Decreased urine output
• Increased heart rate or irregular heartbeat
• Muscle cramps
• Pain in the back, flank, or abdomen

• Arterial blood gas (ABG) and blood chemistries may indicate metabolic acidosis and low blood potassium level.
• Blood pH and the urine pH may show poor hydrogen ion excretion. The urine pH is usually > 5.0.
• Urinalysis may show abnormalities, including increased levels of calcium and potassium in the urine.

The goal is to restore the normal pH (acid-base level) and electrolyte balance. This will indirectly correct bone disorders and reduce the risk of calcium build-up in the kidneys (nephrocalcinosis) and kidney stones. The underlying cause should be corrected if it can be identified.

Alkaline medications such as potassium citrate and sodium bicarbonate correct the acidic condition of the body. Sodium bicarbonate may correct the loss of potassium and calcium.

Vitamin D and calcium supplements are usually not given because there may be too much calcium in the kidneys, even after bicarbonate therapy.

The disorder must be treated to reduce its effects and complications, which can be permanent and/or life-threatening. Most cases get better with treatment.

• Osteomalacia
• Rickets
• Nephrocalcinosis
• Kidney stones
• Electrolyte imbalances, such as low blood potassium level

Call your health care provider if you have symptoms of distal renal tubular acidosis.

Get help immediately if you develop emergency symptoms, such as:

• Decreased consciousness
• Seizures
• Severe decrease in alertness or orientation

There is no prevention for this disorder.