Type 1 RTA: Decreased tubular H+ secretion by type A intercalated cells. NAGMA, Urine pH > 5.5 (N < 5.0), Serum HCO3 = 10-20 mEq/L (N = 25), FEHCO3 = 3-5% (N< 0.1%), Hypokalemia (non-reabsorbale anion in the distal nephron)
Causes: Inherited childhood type (w/wo hearing loss). Acquired type (autoimmune diseases (Sjogrens, SLE), Amphotericin B (antifungal), Chronic toluene (glue) sniffing)
Complications: Ca2+ kidney stones (chronic Ca2+ loss from bone), Osteoporosis and/or Osteomalacia (chronic metabolic acidosis -> decreased bone formation by lowering circulating levels of TH, GH, and Calcitriol), short stature, failure to thrive, rickets