NEPHROLOGY
Etiology
Autoimmune (Sjogren’s), drugs (amphotericin B), CKD
Hereditary tubular defects
Hyperkalemic causes (hypoaldosteronism)
Pathogenesis
Impaired acid secretion or bicarbonate reabsorption → metabolic acidosis
Types I (distal), II (proximal), IV (hyperkalemic)
Clinical Features
Metabolic acidosis with normal anion gap
Hypokalemia (types I and II)
Kidney stones (type I)
Growth failure in children
Treatment
Oral bicarbonate
Potassium citrate
Treat underlying cause
Fludrocortisone for type IV