Pseudo-Renal Tubular Acidosis: Conditions Mimicking Renal Tubular Acidosis
Uduman J, and Yee J. Pseudo-renal tubular acidosis: Conditions mimicking renal tubular acidosis. Adv Chronic Kidney Dis 2018; 25(4):358-365.
Advances in chronic kidney disease
Hyperchloremic metabolic acidosis, particularly renal tubular acidosis, can pose diagnostic challenges. The laboratory phenotype of a low total carbon dioxide content, normal anion gap, and hyperchloremia may be misconstrued as hypobicarbonatemia from renal tubular acidosis. Several disorders can mimic renal tubular acidosis, and these must be appropriately diagnosed to prevent inadvertent and inappropriate application of alkali therapy. Key physiologic principles and limitations in the assessment of renal acid handling that can pose diagnostic challenges are enumerated.