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Successful Management of Refractory Type 1 Renal Tubular Acidosis with Amiloride
Joint Authors
Chow, Robert D.
Oguejiofor, Patrick
Yim, Kenneth
Jaar, Bernard G.
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-3, 3 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-01-03
Country of Publication
Egypt
No. of Pages
3
Main Subjects
Abstract EN
A 28-year-old female with history of hypothyroidism, Sjögren’s Syndrome, and Systemic Lupus Erythematosus (SLE) presented with complaints of severe generalized weakness, muscle pain, nausea, vomiting, and anorexia.
Physical examination was unremarkable.
Laboratory test showed hypokalemia at 1.6 mmol/l, nonanion metabolic acidosis with HCO3 of 11 mmol/l, random urine pH of 7.0, and urine anion gap of 8 mmol/l.
CT scan of the abdomen revealed bilateral nephrocalcinosis.
A diagnosis of type 1 RTA likely secondary to Sjögren’s Syndrome was made.
She was started on citric acid potassium citrate with escalating dosages to a maximum dose of 60 mEq daily and potassium chloride over 5 years without significant improvement in serum K+ and HCO3 levels.
She had multiple emergency room visits for persistent muscle pain, generalized weakness, and cardiac arrhythmias.
Citric acid potassium citrate was then replaced with sodium bicarbonate at 15.5 mEq every 6 hours which was continued for 2 years without significant improvement in her symptoms and electrolytes.
Amiloride 5 mg daily was added to her regimen as a potassium sparing treatment with dramatic improvement in her symptoms and electrolyte levels (as shown in the figures).
Amiloride was increased to 10 mg daily and potassium supplementation was discontinued without affecting her electrolytes.
Her sodium bicarbonate was weaned to 7.7 mEq daily.
American Psychological Association (APA)
Oguejiofor, Patrick& Chow, Robert D.& Yim, Kenneth& Jaar, Bernard G.. 2017. Successful Management of Refractory Type 1 Renal Tubular Acidosis with Amiloride. Case Reports in Nephrology،Vol. 2017, no. 2017, pp.1-3.
https://search.emarefa.net/detail/BIM-1147017
Modern Language Association (MLA)
Oguejiofor, Patrick…[et al.]. Successful Management of Refractory Type 1 Renal Tubular Acidosis with Amiloride. Case Reports in Nephrology No. 2017 (2017), pp.1-3.
https://search.emarefa.net/detail/BIM-1147017
American Medical Association (AMA)
Oguejiofor, Patrick& Chow, Robert D.& Yim, Kenneth& Jaar, Bernard G.. Successful Management of Refractory Type 1 Renal Tubular Acidosis with Amiloride. Case Reports in Nephrology. 2017. Vol. 2017, no. 2017, pp.1-3.
https://search.emarefa.net/detail/BIM-1147017
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1147017