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Acidosis tubular renal proximal - Treatment

Nombres alternativos

ATR tipo II; ATR proximal; Acidosis tubular renal tipo II

Tratamiento:

El objetivo del tratamiento es restaurar el pH normal (nivel ácido-básico) y el equilibrio electrolítico normal del cuerpo. Esto corregirá indirectamente los trastornos óseos y reducirá el riesgo de osteomalacia y osteopenia en adultos.

Es posible que algunos adultos no requieran ningún tratamiento, pero todos los niños requieren terapia con álcali para evitar la osteopatía inducida por ácidos, como el raquitismo, y permitir el crecimiento normal. Asimismo, si se puede identificar la causa subyacente, se debe corregir.

Los medicamentos alcalinos, incluyendo el citrato de potasio y el bicarbonato de sodio, corrigen el estado ácido del cuerpo y los niveles bajos de potasio. Igualmente, los diuréticos tiazídicos pueden indirectamente disminuir la pérdida de bicarbonato, pero pueden agudizar los niveles bajos de potasio.

Posiblemente se necesiten suplementos de vitamina D y calcio para ayudar a reducir las deformidades del esqueleto que resultan de la osteomalacia o el raquitismo.

Expectativas (pronóstico):

Aunque la causa de la acidosis tubular renal proximal se puede resolver por sí sola, los efectos y complicaciones pueden ser permanentes o potencialmente mortales. El tratamiento generalmente es exitoso.

Complicaciones:

  • Desequilibrios de electrolitos, como la hipocaliemia
  • Osteomalacia
  • Raquitismo

Situaciones que requieren asistencia médica:

Consulte con el médico si tiene síntomas de acidosis tubular renal proximal.

Consiga ayuda inmediatamente si desarrolla cualquiera de los siguientes síntomas de emergencia:

  • Reviewed last on: 11/30/2009
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Herbert Y. Lin, MD, PHD, Nephrologist, Massachusetts General Hospital; Associate Professor of Medicine, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Referencias

Seifter JL. Acid-base disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 119.

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