Clinical forms of the distal tubular acidosis

August 12, 2017 17:51 | Genetic Diseases

1. Primary hereditary forms: nephrocalcinosis.

2. Secondary forms:

1) immune pathology tubules;

2) transplanted kidney;

3) interstitial nephritis papillita;

4) medullary cystic kidney;

5) cirrhosis of the liver;

6) medicinal effect - amphotericin B, vitamin D, Li;

7) after obstruction diuresis;

8) hypoaldosteronism.

Treatment of renal tubular acidosis should be directed primarily at correcting the disturbed acid-base balance in the body.For this purpose, solutions of sodium bicarbonate are introduced.By reducing the amount of potassium in blood serum to be administered potassium supplements (such as in the age Pananginum doses).In the complex treatment of acidosis are encouraged to include the reception citrate compounds (citric acid, sodium citrate or potassium, distilled water).

With symptoms of osteoporosis and osteomalacia (softening of bone tissue due to the leaching of calcium from it) shows the assignment of vitamin D or its metabolites (oksidevita).When hypocalcemia (reducing the amou

nt of calcium in blood serum) is recommended to use calcium preparations (calcium gluconate) to normalize the level of calcium in the blood.In the formation of kidney stones using magnesium oxide recommended courses of 3-4 weeks for a long time (2-3 years).In order to prevent the formation of kidney stones it is advisable to exclude from the diet foods rich in oxalates (spinach, tomato juice, chocolate, etc.).Drug treatment should be carried out against the background of a restorative treatment with the inclusion of alkaline mineral waters (Borjomi type), fruit juices, food restriction of animal protein (potato diet), use of a complex of vitamins (A, E, group B).

Under the influence of a complex of medical treatment improves the general condition, calcium-phosphorus metabolism, blood alkaline phosphatase activity is determined by the positive dynamics of x-ray picture of the structural changes in bone tissue.Special monitoring should be carried out for the performance of blood pH, and urine parameters of calcium and phosphorus in the blood, the determination of which should be 1 every 7-10 days.

Surgical treatment may be recommended only for children with severe bone deformities of the lower limbs, which impede their movement.For this to be achieved 2-year stabilization of clinical and biochemical parameters.

Forecast worsens accession pyelonephritis, nephrolithiasis, and the development of chronic renal failure.