Clinical characteristics of renal tubular acidosis in adults and children

Objective To view and compare the clinical characteristics of renal tubular acidosis in adults and children. Methods Clinical data of patients with renal tubular acidosis diagnosed by Shandong Provincial Hospital affiliated to Shandong University from Jan 1991 to Sep 2017 were reviewed. The difference and consistency in clinical characteristics of renal tubular acidosis between adults and children were analyzed. Results Data from 206 adults and 60 children were analyzed. 89.81% cases in adults were secondary to other diseases, mainly primary Sjogren's syndrome. Most children patients (81.67%) were idiopathic, others largely originated from inherited metabolic diseases. The most common subtype of both was distal renal tubular acidosis. Proximal renal tubular acidosis was easier to be found in idiopathic renal tubular diseases of children. Chief complaints or starting symptoms were mainly composed of polydipsia with polyuria (41.4%) and fatigue (35.3%). Children were typical of growth retardation, rickets and digestive symptoms. The rate of missed diagnosis and misdiagnosis was 41.4 percent. Routine therapy consisted of healing metabolic acidosis and electrolyte disorders, treating underlying diseases and preventing complications. The majority of patients (95.5%) improved after treatments. Conclusions Renal tubular acidosis possesses various underlying diseases, diverse clinical manifestation and high rate of misdiagnosis. Given the high incident of secondary types, investigation of underlying disease, especially autoimmune diseases such as Sjogren's syndrome, is of great importance in adults. Most children patients suffer from primary renal tubular acidosis. Attention should be paid to them in order to reduce the rate of misdiagnosis and teratogenicity.