Pediatric renal tubular acidosis (RTA) is a group of disorders characterized by impaired acid-base regulation in the renal tubules, leading to metabolic acidosis. This comprehensive review provides an overview of the etiology, pathophysiology, clinical manifestations, diagnosis, and management of pediatric RTA. Etiologies of pediatric RTA include genetic mutations, autoimmune disorders, drug-induced causes, and systemic diseases affecting renal function. Pathophysiologically, RTA involves defects in renal tubular transport mechanisms, leading to impaired reabsorption of bicarbonate and/or impaired secretion of hydrogen ions. Clinical manifestations of pediatric RTA vary depending on the underlying subtype and may include failure to thrive, growth retardation, polyuria, dehydration, nephrocalcinosis, and electrolyte disturbances. Diagnosis of pediatric RTA involves clinical evaluation, laboratory tests, and specialized renal function studies, including measurement of urinary electrolytes, blood gas analysis, and assessment of acid-base status. Management of pediatric RTA aims to correct metabolic acidosis, restore electrolyte balance, prevent complications such as nephrocalcinosis and bone demineralization, and address the underlying cause. Treatment modalities include alkali therapy, potassium supplementation, and avoidance of medications that exacerbate acidosis. This review highlights the importance of early recognition and appropriate management of pediatric RTA to optimize outcomes and prevent long-term complications.

Pediatric, renal tubular acidosis, acid-base imbalance

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