Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be talking to you about renal tubular

acidosis.

And you can find written notes on this topic at zero to finals.com slash renal tubular acidosis

or in the renal medicine section of the second edition of the

zero to finals medicine book. And you can find flashcards and questions to train your knowledge

on this content and help you remember the information for longer at members.0.0.com. So let's get

straight into it.

Rinal tubular acidosis involves metabolic acidosis due to pathology in the tubules of the kidneys.

The tubules balance hydrogen ions, or H-plus, and bicarbonate ions, or H-CO-3-minus, between the blood and the urine,

to maintain a normal pH of the blood.

There are four types of renal tubular acidosis, each with different pathophysiology.

To start with a basic summary, type 1 renal tubular acidosis is where the distal tubule cannot excrete hydrogen ions. The urinary pH is high and the serum potassium is low.

Type 2 renal tubular acidosis is where the proximal tubule cannot reabsorborbidic.

The urinary pH is high and the serum potassium is low.

And type 4 renal tubular acidosis is where there's a low aldosterone or impaired aldosterone function, the urinary pH is low and the serum

potassium is high.

And we'll go into more detail about how these work shortly.

A tom tip for you, remember type 1 and type 4 for your exams.

Type 4 is the most common type. Both type 1 and type 4 involve

inadequate excretion of hydrogen ions in the distal tubules. In type 1 there is hypochalemia or a low

potassium and in type 4 there is hypercalaemia or raised potassium.

...