Distal renal tubular acidosis with hyperkalemia due to obstructive uropathy
Korman, S.; Borochovitz, Z.; Hochberg, Z.
Harefuah 107(3-4): 62-64
1984
ISSN/ISBN: 0017-7768 PMID: 6510793 Document Number: 233539
A 2-mo. old infant with an obstructed right kidney and a hypoplastic left kidney had distal renal tubular acidosis (DRTA) and hyperkalemia. Urinary tract obstruction, unilateral or bilateral, may lead to disturbances in urinary concentration and acidification. The disturbance in DRTA is usually accompanied by hypokalemia. Surgical release of the obstruction of the right kidney and the administration of sodium bicarbonate led to gradual improvement in H-excretion by the distal tubule and to normokalemia. Urinary tract obstruction should be considered in the differential diagnosis of DRTA with hyperkalemia, and conversely, in urinary tract obstruction, DRTA should be considered. It can be diagnosed by the difference between urinary and blood pCO2 [partial pressure CO2].