Q:

What is the management of RTA?

waelhammad
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2022-11-19
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An 8-year-old male presents with concern for bilateral genu valgum deformity and complaint of pain in both lower limbs on walking or running. Parents note that he has always been the shortest boy in his class at school and his complaints of pain on walking and lower limb deformity have developed and progressed over the past six months. Patient and parents deny any trauma, and there is no history of fractures. Patient does not have any alopecia, or dental problems such as discoloration or abscesses. Patient has a history of polyuria and primary nocturnal enuresis.

What is the management of RTA?

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waelhammad
2022-11-19
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Any underlying disease leading to RTA has to be identified and managed. Patients with proximal RTA require bicarbonate equivalent up to 20 mEq/kg/day in the form of sodium bicarbonate or sodium citrate solution.

Patients with distal RTAs generally require 2–4 mEq/kg/day bicarbonate equivalent and should be monitored for the development of hypercalciuria. Those with symptomatic hypercalciuria, nephrocalcinosis, or nephrolithiasis (recurrent episodes of gross hematuria) may require thiazide diuretics to decrease urine calcium excretion. Electrolyte abnormalities such as hypokalemia, hyperkalemia and hypophosphatemia need to be monitored with appropriate therapy.

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