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KIDNEY TUBULAR ACIDOSIS: CAUSES, SYMPTOMS, DIAGNOSTICS, TREATMENT (LITERATURE DATA AND THE AUTHORS’ OWN OBSERVATIONS)

The article presents a literature review on the etiology, pathogenesis, clinical presentation, diagnosis and therapy of renal tubular acidosis in children, as well as our own 9-years-long observation of a child with this disease. Clinical manifestations from the initial symptoms starting at 3.5 years of age in the form of recurrent acetonemic states, episodes of dehydration with fever, and polyuria were analyzed. Further dynamics of symptoms was traced in the form of severe weakness in the legs, rapid fatigue, gait disturbance, inability to running, jumping, X-shaped deformity of the lower extremities. The literature data on the erroneous prescription of massage to a child with rickets-like diseases without normalization of phosphorus-calcium metabolism and disappearance of acidosis signs are presented. A thorough analysis of these mistakes was carried out and the positive dynamics was demonstrated in the clinical condition and development of the child in response to adequate treatment after a correctly made diagnosis. The differential diagnosis was carried out with Fanconi's syndrome, proximal RTA, hyperparathyroidism, primary hyperoxaluria. Molecular genetic study permitted to exclude cystinosis. Such children require constant monitoring and treatment by specialists, primarily from the point of view of preventing the renal failure progression. Knowledge of the features of renal tubular acidosis course will significantly help the clinicians in making the diagnosis, prescribing consultations of narrow specialists, as well as choosing an adequate treatment tactics.