The Curbsiders Internal Medicine Podcast16 Jul 2018

#104: Renal tubular acidosis with Kidney Boy, Joel Topf MD

Renal tubular acidosis aka RTA deconstructed by @Kidney_Boy, Joel Topf MD, Chief of Nephrology at Kashlak Memorial Hospital. We review the three buckets of non gap metabolic acidosis, normal renal physiology & acid base handling, points of failure in RTA, complications and treatment of RTA. Check out Dr Topf’s awesome slides on renal tubular acidosis at http://thecurbsiders.com/podcast .

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Credits:

Written by: Matthew Watto MD and Joel Topf MD
Produced by: Matthew Watto MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
Guest: Joel Topf MD

Time Stamps

00:00 Announcements
01:02 Disclaimer
01:40 Intro and guest bio
04:00 Joel’s one liner
06:05 Joel’s “favorite failure”
11:45 Paul shares a failure
13:20 Tweetorials
16:39 Clinical case of non gap metabolic acidosis
18:06 Three buckets of NAGMA and GI losses
21:02 Chloride intoxication and normal saline
25:14 Renal tubular acidosis and normal role of kidney in acid base
35:03 Proximal (type 2) RTA
40:33 Cases of proximal RTA
43:38 Distal (type 1) RTA
53:15 Bicarbonate dosing and titration
55:28 Type 4 RTA (hypoaldosteronism)
62:09 Urinary anion gap and ammonium
67:26 Replacing GI losses of bicarbonate
70:25 Joel reviews quick cases of RTA and NAGMA
74:49 Outro

Tags: renal, tubular, acidosis, non, gap, rta, nagma, metabolic, kidney, diarrhea, sodium, normal, saline, ringer's, lactate, tubule, bicarbonate, physiology, acid, base, ammonia, ammonium, nephrolithiasis, assist

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