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Old 05-01-2011
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Kidney Why Hypokalemia in Renal Tubular Acidosis

what is the mechanism of hypokalemia in renal tubular acidosis type 1 and 2??
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type1 RTA is associated with failure to acidify urine n excrete H+
so the defect in collecting duct is in H+/K+ pump
failure to take up K in xchange fr H = hypokalemia

type2 RTA is due to failure of HCO3- reabsorption it produces negative charge in lumne tht attracts K+ n thus its xcreted = hypokalemia

nw cn any1 help me understand risk of Ca stones in type1 i think its due to alkaline urine????
n wt abt hypophosphatemic rickets in type 2 ????
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Old 05-01-2011
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Nephrocalcinosis in Type I (distal) RTA

There is impaired H+ secretion because of H+/K+ pump dysnfunction in the intercalated cell. So there is acidemia (metabolic acidosis) with highly alkaline urine. The bone buffers the acid and releases calcium phosphate in blood. Tubular reabsoprtion of Calcium phosphate is therefore reduced. For this reason and the alkaline urine, stone formation is favorable. And also, acidemia causes more tubular reabsorption of citrate. (Citrate being a stone formation INHIBITOR by forming soluble complex with Ca.)

Type II RTA (HCO3- pump dysfucntion)
One of the causes for proximal RTA is primary HyperPTH.
PTH inhibits Na+/phosphate co-transport in prox convo tubule and causes phosphate excretion. (first aid 2010) Normally 85% of phosphate is reabosrbed @PCT.
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