Distal Renal Tubular Acidosis and Severe Hypokalemia

A Case Report and Review of the Literature

George Vasquez-Rios; David John Westrich Jr; Isaac Philip; John C. Edwards; Stephanie Shieh


J Med Case Reports. 2019;13(103) 

In This Article


Distal renal tubular acidosis (dRTA) is characterized by a failure to acidify the urine in the distal parts of the nephron.[1,2] Frequently, patients present with minimal or no symptoms, which can lead to a delay in diagnosis. Progressively, it can lead to marked acid-base abnormalities, including hyperchloremic metabolic acidosis and severe hypokalemia, which can be fatal. In children, dRTA is usually associated with a genetic defect or anatomic abnormality of the urinary system.[3] In contrast, dRTA in adults is frequently related to acquired conditions such as infections, drugs, and autoimmune diseases. We describe a case of a woman with multiple episodes of severe hypokalemia and weakness as the main reason for admission.