Renal Tubular Acidosis, or ATR, is an alteration related to the process of renal tubular reabsorption of bicarbonate or excretion of hydrogen in the urine, resulting in an increase in the pH of the body known as acidosis, which can result in delayed growth in children, difficulty to gain weight, muscle weakness and decreased reflexes, for example.
It is important that RTA is identified and treated quickly through the intake of bicarbonate as recommended by the doctor to avoid complications, such as osteoporosis and loss of kidney function, for example.
How to Identify Renal Tubular Acidosis
Tubular Renal Acidosis is often asymptomatic, however as the disease progresses some symptoms may appear, especially if there is no maturation of the excretory system. It is possible to suspect ART in the child when it is not possible to perceive correct growth or weight gain, and it is important to take the child to the pediatrician to make the diagnosis and start treatment.
The main indicative signs of Renal Tubular Acidosis are:
- Developmental delay; Difficulty for children to gain weight; Nausea and vomiting; Kidney stones; Gastrointestinal changes, with constipation or diarrhea; Muscle weakness; Decreased reflexes; Delayed language development.
Children diagnosed with ART can lead a completely normal and quality life as long as they perform the treatment correctly to avoid complications. However, it is possible that they become more susceptible to infections due to the greater fragility of the immune system.
In some cases, the symptoms of Renal Tubular Acidosis may disappear between 7 and 10 years of age due to the maturation of the kidneys, with no need for treatment, only medical monitoring to assess whether the kidneys are, in fact, functioning correctly.
Cause and diagnosis of ART
Tubular Renal Acidosis can happen due to genetic and hereditary changes, in which the person is already born with changes in the renal tubule transport process, being classified as primary, or due to adverse drug effects, immaturity of the kidneys at birth or as a consequence other diseases, such as diabetes, sickle cell disease or lupus, for example, in which the kidney changes happen over time.
The diagnosis of ART is made based on the symptoms presented by the person and blood and urine tests. In the blood test, the concentration of bicarbonate, chloride, sodium and potassium is evaluated, while in the urine the concentration of bicarbonate and hydrogen is mainly seen.
In addition, ultrasound of the kidneys may be indicated to check for the presence of kidney stones, or X-rays of the hands or feet, for example, so that the doctor can check for bone changes that can interfere with development of child.
How the treatment is done
The treatment of Renal Tubular Acidosis is done according to the guidance of the nephrologist or pediatrician, in the case of children, and involves taking bicarbonate daily in an attempt to reduce acidosis in both the body and urine, improving the functioning of the body.
Despite being a simple treatment, it can be quite aggressive to the stomach, which can result in gastritis, for example, generating discomfort for the person.
It is important that the treatment is done according to the doctor's recommendation to avoid the occurrence of complications related to excess acid in the body, such as bone deformations, the appearance of calcifications in the kidneys and kidney failure, for example.
