Causes And First Symptoms Analysis Of65Cases Of Renal Tubular Acidosis

Objective: To improve the further understanding of renal tubularacidosis (RTA) by performing a retrospective analysis of the etiology,clinical characteristics and treatment outcomes of RTA, so that earlydiagnosis, reasonable intervention, a prospective outcome and a goodquality of life can be achieved.Methods:65patients who were diagnosed with RTA at the FirstHospital of Jilin University from January2000to February2015werecollected. Each patient’s gender, age, initial symptoms, etiology,biochemical indexes (such as serum sodium (Na), potassium(K),chlorine(Cl), phosphorus(P), BUN, CRE, pH), urine index (urine pH, specificgravity of urine, etc.), immune indexes (anti SSA antibody, anti SSBantibody, etc.) were collected.Results:1. The average age of the65patients with RTA was42.41±11.73years old(18-72),52of them(80.0%) were female,3case(20.0%)were male. About50(76.9%) of them are in age41to65.2. In allpatients,41cases (63.1%) had the symptom of myasthenia, which wasthe most common initial symptom. The rest of the symptoms includedurinary tract (25cases), dry mouth and dry eyes (20cases), skeletal changes (15cases).3. All of the30patients with Sjogrensyndrome were analyzed by immunological indexes,23cases (76.7%)were anti SS-A positive and15cases (30%) were anti SS-B positive.Mild reduction of the NH+4in urine was found in3mild acidosis patients,this was diagnosed by Calcium chloride load test.4. Clinical types: type IRTA was found in51patients（78.4%）, about26are Sjogren syndrome(87%); type II RTA was found in11patients (17.0%),7of them arechronic glomerulonephritis (63.6%);3patients(4.6%) are type Ⅳ RTA,all of them are chronic renal insufficiency.5. Patients with Sjogrensyndrome, systemic lupus erythematosus and mixed connective tissuediseases were treated by hormone and immunosuppressant.3patientswith the Sjogren syndrome have undergone mild or moderate renalinsufficiency due to the irregular treatment;1patient with systemic lupuserythematosus experienced clinical deterioration due to thediscontinuation of treatment;2patients with hyperthyroidism wascontrolled by antithyroid drugs, the electrolyte and acidosis werecorrected;2patients with rheumatoid arthritis was treated by rheumatoidarthritis, the joint pain had improved and the biochemical index decreased;the rest patients were given etiological therapy and supportive treatment,they were in a stable condition.6. Most of the65patients are caused bythe secondary factors, mainly are autoimmune diseases (40cases,61.5%),among the40patients,30are the Sjogren syndrome, which was the most common, accounting for75%.Conclusion:1. One of the most common symptoms in RTA was myasthenia. Forpatients with myasthenia for unknown reason, we should test the serumpotassium (K), pay attention to the danger of RTA.2. Autoimmune disease was the most common cause of thesecondary RTA. For middle-aged women patients with RTA, we shouldlook for the evidence actively, make the etiological therapy timely, andgain a prospective outcome at last．...