Clinical Analysis Of 195 Cases Of Renal Tubular Acidosis

ObjectiveTo analysize the etiology , clinical features, causes of renal tubular acidosis (RTA)in a large number of Chinese cases, and to summarize the successful experience in this disorder for improving its diagnosis and treatment.Methods195 cases with RTA hospitalized in PLA General Hospital in recent 20 years were retrospectively analysized. All the clinical and laboratory data, as well as complications and outcomes of treatment were summarized.ResultsIn this cohort,there were 51 male and ]44 female cases,with age ranging from 2 to 79 years old. (1) Etiology: The etiology of RTA was complex and diverse, covering Sjogren’s syndrome(SS),medullary sponge kidney,renal toxicity drugs, chronic hepatitis B and so on. Primary RTA accounted for 23.1% and secondary RTA accounted for 76.9%. The etiology of RTA included Sjgren’s syndrome (SS) (42.6%) .chronic kidney disease ( 12.8% ) ,nephrotoxicity drugs ( 4.1% ) and so on. The Sjogren’s syndrome(SS) was the most important secondary cause. (2) Clinical manifestations:Clinical manifestations of RTA were various and complex, because multiple systems and organs were involved in this disorder. So it was easy to induce a variety of complications with non-specificity. The most common initial symptoms were feebleness (69.7%),followed by polydipsia and polyuria (45.6%),limbs paralysis(39.5%),arthralgia (33.8%) , etc. Patients often looked for medical care in various departments, resulting in high rate of misdiagnosis (21%). (3) Diagnosis and treatment:With etiology and phenotype clearly identified, patients with RTA all got effective treatments. Especially for the active SS, immune suppressive therapy got significant effects. The routine treatment on metabolic acidosis and electrolyte disturbances were performed. Immune suppressive therapy with glucocorticoid or/and cytoxan on active SS(83 cases), systemic lupus erythematosus (2 cases) , rheumatoid arthritis (2 cases) was effective in disease relief and antibody titers depression.ConclusionClinicians should strengthen the understanding of the complex causes and the various clinical manifestations of RTA. Early diagnosis and effective treatment,especially immune suppressive therapy on active autoimmune diseases, can improve the patients’ quality of life and reduce the complications. Clinicians should strengthen the understanding of the complex causes and the various clinical manifestations of RTA.Early diagnosis and effective treatment can improve the patients’ quality of life and reduce the occurrence of complications.