Renal tubular acidosis occurs when the kidneys cannot remove excess acid from the blood. This can result in high acid levels and health problems. Alkali treatment with sodium bicarbonate can treat renal tubular acidosis.

Renal tubular acidosis (RTA) is a rare condition that causes high levels of acid in the blood due to a kidney problem that prevents them from effectively removing acid.

Acid is a waste product from the body, which the kidneys remove from the blood and eliminate through urine. High levels of acid in the blood can lead to health problems.

This article looks at the treatment options for RTA, side effects, and treatment outcomes.

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RTA is when the kidneys cannot remove acid, a waste product, from the body.

If the kidneys cannot remove acid effectively from the blood into the urine, acid levels in the blood can become too high, causing acidosis. Excess acid in the blood can cause problems with how the body functions.

Factors that may increase the risk of RTA include:

Tubules are tiny structures within the kidneys that return substances to the blood that the body needs and remove waste products.

There are different types of RTA, depending on where the problem occurs in the tubules. The three main types of RTA are:

  • Distal RTA: an issue at the end, or distal area, of the tubules
  • Proximal RTA: an issue with the beginning, or proximal area, of the tubules
  • Hyperkalemic RTA: occurs if the tubules are not able to remove enough potassium, which then affects how the kidneys remove acid

Healthcare professionals do not usually classify RTA into hyperkalemic RTA as they see it as a combination of distal and proximal RTA.

Healthcare professionals may also categorize RTA as primary if it is an inherited condition or secondary if it is due to a medication or other health condition. Primary distal RTA is the most common type of RTA.

The goal of treatment for RTA is to lower acid levels in the blood and return them to a normal range.

Treatment also aims to prevent complications from RTA, such as kidney stones or kidney failure.

If people have RTA causing high potassium levels, the goal of treatment is to also reduce potassium levels in the blood.

If people have underlying conditions that are causing RTA, treatment will also focus on treating the underlying condition.

Doctors treat all types of RTA with sodium bicarbonate or sodium citrate, which people drink.

Sodium bicarbonate and sodium citrate are forms of alkali therapy. Alkalis are a chemical compound that neutralizes the buildup of acid in the blood.

Infants with distal RTA may need potassium supplements if RTA causes potassium levels to fall. Older children and adults will not usually need potassium supplements, as alkali treatment stops the kidneys from getting rid of potassium in the urine.

Adults with proximal RTA may also need vitamin D supplementation to protect bone health.

Dietary changes may also help treat RTA. A diet high in animal products may produce higher levels of acid than a plant-based diet. People may reduce their animal protein intake and increase their intake of plant foods, including alkali-producing fruits and vegetables.

Increasing the intake of alkali foods, such as fruit and vegetables, and limiting acid-producing foods, such as animal products, may be an effective treatment for acidosis.

Learn more about a plant-based diet here.

Side effects of sodium bicarbonate may include:

It is important to get the right balance of alkali therapy, as alkalosis can occur if acid levels in the blood drop too low, which can also cause problems.

A person should only take sodium bicarbonate under the guidance of a doctor.

Learn more about the dangers of drinking baking soda here.

Treatment will depend on the underlying cause of RTA. If the cause is reversible, then the outcome is good.

Distal RTA is usually easily treated with sodium bicarbonate, which absorbs into the tubule and resolves RTA.

In children, alkali therapy for distal and proximal RTA can help lower acid levels in the blood and help prevent bone disorders, kidney stones, and slow growth.

Adults may have to take additional vitamin D supplements to prevent bone disorders.

People may want to write down any questions before talking with a doctor to ensure they get all the necessary information. People may wish to ask:

  • What type of RTA do I have?
  • What is the cause of my RTA?
  • What will the treatment involve?
  • What side effects might treatment cause?
  • Will I have to take any additional supplements, such as potassium or vitamin D?
  • Is there a type of diet that is best to eat with RTA?
  • Are there any other lifestyle changes that may help?
  • What are the outcomes of treatment?
  • How long will treatment take?
  • Are there any other health problems that require treatment?

RTA is a condition in which the kidneys cannot remove excess acid from the blood, leading to high levels of acid that can cause health problems.

To treat RTA, doctors will give people an alkali solution consisting of sodium bicarbonate or sodium citrate to drink. This neutralizes the acid and prevents any further damage to the body.

In some cases of RTA, people may also need potassium supplements to correct low potassium levels. Some people may also need to supplement with vitamin D.