Renal Tubular Acidosis - Differential Diagnosis Algorithm
Decreased Serum K, Urine pH < 5.5 - Proximal RTA
Decreased Serum K, Urine pH > 6.0 - Hypokalemic distal RTA
Increased Serum K = Hyperkalemic Renal Tubular Acidosis
 • Urine pH < 5.5 - ↓ Aldosterone level or activity, Calcineurin inhibitors, Aldosterone antagonists, Pseudohypoaldosteronism, Urinary tract obstruction
 • Urine pH > 6.0
     - Tubulointerstitial injury: Urinary tract obstruction, Chronic interstitial nephritis, Sickle cell nephropathy
     - Drugs that block ENaC: Amiloride, Triamterene, Pentamidine

Dr. Jain via UNC IM Chiefs @uncimchiefs

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