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Renal Tubular Acidosis

Each time our internal organs do something, such as digesting food or healing damaged tissue, chemical reactions take place in the body's cells. These reactions cause acid to go into the bloodstream.

Normally, the kidneys remove excess acid from blood, but certain diseases, genetic defects, or drugs can damage a kidney's ability to do this important job. This can allow too much acid to build up in the blood and cause problems. When this happens, it's called renal tubular acidosis (RTA).

Without treatment, RTA can affect a child's growth and cause kidney stones, fatigue, muscle weakness, and other symptoms. Over time, untreated acidosis can lead to long-term problems like bone disease, kidney disease, and kidney failure.

Fortunately, such complications are rare, since most cases of RTA can be effectively treated with medicines or by treating the condition that's causing the acid to build up.

How the Kidneys Work

The kidneys are a pair of bean-shaped organs located toward the back of the abdominal cavity, just above the waist. The kidneys remove waste products and extra water from the food a person eats, returning chemicals the body needs (such as sodium, phosphorus, and potassium) back into the bloodstream. The extra water combines with other waste to become urine (pee).

The main functional units of the kidneys, where the blood filtering happens, are tiny structures called nephrons. Each kidney has about a million nephrons, and each nephron has a renal tubule, a tube where the acid and waste products filtered from the blood are secreted into urine.

Having a disease or defect can interfere with how the renal tubules function, which can lead to RTA.


There are a few different kinds of RTA. The first two types are named for the part of the renal tubule in which the damage or defect is found.


A lot of the time, kids with RTA don't have any symptoms and may not know they have the disease until it shows up on a blood or urine test.

For some kids, the first symptom of RTA is kidney stones, which can cause symptoms like:

Over time, RTA can affect bone development and keep a child from growing as much as he or she should. This is often why doctors suspect RTA in the first place.

Other symptoms of RTA you might notice include:


If your child shows any symptoms of RTA, see a doctor right away. The sooner something is done about the condition, the more effective treatment will be.

To diagnose RTA, the doctor will do a physical examination and take a sample of your child's blood for testing. He or she also may want a urine sample. If test results suggest that your child might have RTA, the doctor will work with you to decide the best way to treat it.


How RTA is treated depends on what's causing it. If it's a reaction to a certain drug, treatment may involve stopping use of the drug or changing the dosage. If an underlying disease or other condition is causing RTA, it will be treated until that condition resolves.

To treat the effects of RTA, it's necessary to restore a normal acid level to the blood. To do this, doctors prescribe alkaline medicines, such as sodium bicarbonate, that help to lower the blood's concentration of acid.

Most of the time, treatment for RTA is effective. Kids whose RTA is caused by a genetic defect may need treatment for the rest of their lives. The good news is that sticking with their treatments lets kids remain healthy.

Date reviewed: March 2014

Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

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