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 if you want to follow along with written notes on this topic,

you can follow along at zero tofinals.com slash renal tubular acidosis or in the renal section of the zero de finals medicine book.

Let's get straight into it.

Renal tubular acidosis is where there is a metabolic acidosis which is caused by pathology in the tubules

of the kidney.

The tubules are responsible for balancing the hydrogen and the

bicarbonate ions between the blood and the urine, and this helps to maintain a normal pH.

And where this system breaks down, a metabolic acidosis can occur, which is called renal tubular

acidosis. There are four types of renal tubular acidosis and each has

different pathophysiology. Type 1 and type 4 are the two that may come up in your exams and the

most relevant to clinical practice that's worth learning about these two, type 1 and type 4.

Firstly, let's talk about type 1. Type 1, renal tubular acidosis is due to pathology in the distal tubule.

So remember there's a proximal tubule, a loop of henley and then a distal tubule.

And when the distal tubule is unable to excrete hydrogen ions,

so unable to get rid of those hydrogen ions that cause an acidosis

into the urine, this causes a type 1 renal tubular acidosis. There are many different causes

of a type 1 renal tubular acidosis, and these can be genetic causes, and there's both autosomal

dominant and autosomal recessive forms.

Systemic lupus erymatosis can cause it. Shogran syndrome, primary bilari cirrhosis,

hypothyroidism, sickle cell anemia, and Marfan syndrome can all cause a type 1 renal tubular

acidosis. So how does it present? Well, it presents

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