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A Case of Distal Type of Renal Tubular Acidosis in a Neonate

Journal of the Korean Pediatric Society 1992;35(7):1014-1018.
Published online July 15, 1992.
A Case of Distal Type of Renal Tubular Acidosis in a Neonate
Sung Sub Shim, Young Joon Kim, Jae Hong Park, Soo Yung Kim, Chan Yung Kim
Department of Pediatrics, Pusan National University College of Medicine, Pusan, Korea
신생아에서 발병한 원위형 신세뇨관 산혈증 1례
심성섭, 김영준, 박재홍, 김수영, 김찬영
부산대학교 의과대학 소아과학교실
Abstract
A female infant at 38 days of age was admitted to pediatric department of Pusan National University hospital due to dehydration, weight loss, vomiting, polyuria. Physical exmination at the time of admission revealed a slightly anemic, moderately dehydrated, dwarfed female infant in no acute distress. Laboratory studies on admission revealed hypokalemic, hyperchloremic metablic acidosis with normal anion gap and persistent high urine pH. Ultrasonography and computed tomo-graphy of kidney showed bilateral nephrocalcinosis. Urinary bicarbonate fractional excretion demonstrated 5.28% urinary leak of filtred load during sodium bicarbonate infusion over a plasma bicarbonate range of 15 to 25 mEq/liter. The above results suggested distal renal tubular acidosis. After 2 weeks of potassium and alkali replacement therapy, she had improved the clinical symptoms and laboratory findings, but remained nephrocalcinosis radiologically. With the reveiw of literatures, the case is presented.
Key Words: Renal tubular acidosis, Distal type


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