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Renal tubular acidosis, otherwise known as RTA, is a condition that occurs when your blood becomes too acidic because of kidney abnormality. Because of failure of the kidneys to excrete it out of the body, acids build up in the blood, which can lead to growth retardation, kidney stones, bone disease, chronic kidney disease, and possibly total kidney failure.

One of the main functions of your kidneys is to maintain normal levels of acids and bases in your body (acid-base or pH balance). You normally produce acids from chemical reactions that occur when your body is turning food into energy and repairing body tissues. A little acid in your blood is normal. However, too much of this can lead to acidosis, which can affect many of your bodily functions.

A base or alkaline such as bicarbonate can be reabsorbed by your kidneys to help neutralize this acid in the blood. Sometimes, however, something goes wrong and kidney structures are not able to reabsorb bicarbonate. Thus, acid is not neutralized in the blood causing acidosis.

Symptoms of RTA

Depending on the type, cause and structure of the kidneys affected, symptoms of renal tubular acidosis may include:

 Fatigue

 Bone disease such as rickets or osteomalacia

 Impairment of growth

 Kidney stones

 Extreme weakness

 Muscle pain or cramping

 Irregular heartbeat

Sometimes, renal tubular acidosis can lead to chronic kidney disease (CKD) and, possibly, kidney failure if not treated promptly.

Causes of RTA

Causes of renal tubular acidosis may include:

 Inherited diseases, such as cystinosis, hereditary fructose intolerance and Wilson’s disease

 Autoimmune diseases, such as Sjögren’s syndrome and lupus

 Certain drugs like acetazolamide or outdated tetracycline

Some diseases and conditions are associated with RTA including sickle cell anemia, hyperparathyroidism, hyperthyroidism, chronic active hepatitis, primary biliary cirrhosis, a hereditary form of deafness, analgesic nephropathy, rejection of a transplanted kidney, renal medullary cystic disease, obstructive uropathy, and chronic urinary tract infections.

In any case, the main goal of treatment is restoring balance of acids and bases in the blood. However, different treatment options may be needed to treat the different underlying causes of renal tubular acidosis.

Source: Renal Tubular Acidosis (October 2008). National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIH Publication No. 09–4696

Page Last Revised: December 7, 2010

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