Underlying Medical Conditions that Cause Kidney Stones: Distal Renal Tubular Acidosis

Definition 
Distal renal tubular acidosis (dRTA) is a kidney defect that affects its ability to excrete acids from the bloodstream into the urine. Resulting in a condition where there are high amounts of acids in blood and very low amounts of acids in the urine. The kidneys, through hair-like features known as the tubules, also reabsorb bicarbonate, an electrolyte whose function is to maintain a normal balance of acids and bases in the body. Acidosis refers to the condition of chemical imbalance within blood and urine. 
 
Causes 
Causes of dRTA include: 

• Sjogren syndrome, an autoimmune disorder that destroys tear glands and saliva glands. 
• Systemic lupus erythematosus is an autoimmune defect in which the body’s immune mistakenly attacks normal healthy tissue. 
• Amyloidosis, a condition that leads to abnormal protein buildup within bodily tissues and organs 
• High amounts of calcium in the blood 
• Genetics also play a big factor in causing RTA as we inherit certain autoimmune defects from parents. 
• Use of certain medicines that interact with the body and act as a stimulus for RTA disease. Examples of such medication include amphotericin B, lithium, and analgesics. 
 
Effects Arising from Renal Tubular Acidosis  
Renal tubular acidosis creates an environment where little acid is excreted leaving high levels of acids in the blood. Bicarbonates are also reabsorbed in low quantities back into the body, with much of it remaining in the urine. Renal tubular acidosis also affects the balance of electrolytes. Renal tubular acidosis may lead to the following problems: 

• Low or high potassium levels in the blood 
• Calcium deposits in the kidneys, which increases the chances of developing kidney stones. 
• Dehydration 
• Painful softening and bending of the bones. 
 
Persistence of renal tubular acidosis will not only cause kidney stones but may damage kidney tubules and progress to chronic kidney disease. 
 
Symptoms  
Most people have no symptoms and only develop them after the disorder has been present for a long period. Symptoms that manifest vary from one individual to another. Common symptoms include: 

• Neurologic problems may develop when there is a reduction of potassium levels in the blood, leading to diminished reflexes, muscle weakness, and paralysis.  
• Development of kidney stones that cause damage to kidney cells.  
• Adults experience bone pain. 
• Irregular heartbeats and muscle paralysis. 
 
Treatment  
Doctors administer vigorous alkali therapy to their patients; alkali are compounds that neutralize acids. Administration of this therapy leads to normal growth in children, and on many occasions, it has proven to improve other symptoms including lowering the build-up of calcium and calcium stones in the kidneys.  
 
Alkali therapy entails consistent drinking a solution of sodium bicarbonate or sodium citrate every day to counter the effects of acids. The dosage and type of alkali therapy vary and depend on the composition of the patient’s blood serum. Children require larger doses, which are adjusted as they grow.  
 
Advanced treatment should be used if the potassium level does not stabilize; Treatment with alkylating potassium salt like potassium citrate. When calcium stones are present in a patient, then the use of potassium citrate is the best option since sodium encourages the formation of calcium stones. 
 
You should see a doctor immediately you experience symptoms of renal tubular acidosis for timely checkup, treatment and reduce the risks of developing other serious kidney conditions.