Distal Renal Tubular Acidosis, an Uncommonly diag. nosed Cause of Failure to Thrive: Report of Five Cases.

Abstract

Summary: Five cases of distal renal tubular acidosis aged between 24/2 weeks and 2%2 months are described. The presenting features included lethargy, refusal to feed, marked periodic respiration, vomiting and recurrent episodes of unexplained metabolic acidosis. A constant feature was failure to thrive despite caloric intakes in excess of normal requirements. The diagnosis of distal renal tubular acidosis (DRTA) was based on a urine pH>5,5 in a freshly voided urine despite concurrent or induced metabolic acido sis. All the babies responded dramatically to sodium bicarbonate supplement, as baking soda or bicarbonate of soda. The need for increased index of suspicion of DRTA in the evaluation of children in early infancy for failure to thrive and the simplicity of treatment using baking soda is discussed.