RENAL TUBULAR ACIDOSIS (RTA)
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This describes a number of pathophysiologically distinct entities of tubular function whose common feature is the presence of a non-anion-gap metabolic acidosis. Diarrhea, CKD, and RTA together constitute the vast majority of cases of non-anion-gap metabolic acidosis. Pts with earlier stages of CKD (Table 46-1) typically develop a non-anion-gap acidosis, with a superimposed increase in the anion gap at later stages (Chap. 1). Acidosis may develop at an earlier stage of CKD in those with prominent injury to the distal nephron, as for example in reflux nephropathy.