Üç günlük yenidoðanda distal renal tubuler asidoz: Olgu sunumu

Distal renal tubuler asidoz (dRTA), metabolik asidoz, alkali idrar, hipopotasemi veya hiperpotasemi ve hiperkalsiüri ile karakterize genetik bir hastalýktýr. Klinik olarak geliþme geriliði, poliüri, dehidratasyon, kusma ve hipotoni ile birlikte psikomotor geliþme geriliði görülür. Nefrokalsinoz ve/veya ürolitiyazis, hiperkalsiürinin sýk komplikasyonlarý olup böbrek yetmezliði kliniðine neden olabilir. Postnatal üç günlük yenidoðan ateþ ve halsizlik yakýnmalarý ile getirildi. Metabolik asidozu tespit edilen olgunun kan gazýnda pH: 6.89, PCO2: 32.8, PO2: 40.7, HCO3: 6.2, BE – 26.2 idi. Anyon açýðý normal idi. Ýdrar pH: 7 saptandý. Üriner sistem ultrasonografisinde grade 2-3 nefrokalsinoz saptandý. BERA incelemesinde sað kulakta tek taraflý iþitme kaybý saptandý. Bir yenidoðan olgusunda yaþamýn ilk günlerinde metabolik asidoz varlýðýnda mutlaka elektrolit deðerleri ile birlikte anyon açýðý hesaplanmalý ve idrar pH’si kontrol edilmelidir. Bu sayede renal tubuler asidoz olgularýnýn erken taný ve tedavisi mümkün olabilir.

Distal renal tubular acidosis of three days old newborn: a case report

Distal renal tubular acidosis (dRTA) is a genetic disease characterized by metabolic acidosis, alkaline urine, hypokalemia or hyperkalemia, and hypercalciuria. Clinically develpomental delay signs are polyuria, dehydration, vomiting, and psychomotor retardation with hypotonia may be seen. Nephrocalcinosis and urolithiasis are among the complications of hypercalciuria which may lead to renal failure.. A three days old newborn was admitted with complaints of fever and fatigue. The blood gas analysis revealed: pH: 6.89, PCO2: 32.8, PO2: 40.7, HCO3: 6.2, BD: - 2.26. Anion gap was normal. Urine pH was 7. In urinary ultrasonography, grade 2-3 nephrocalsinosis was observed. Right sided hearing loss was found in BAER test. By this way, the early diagnosis and treatment of RTA cases may be possible.When metabolic acidosis is encountered in a neonate during the first days of life after birth, serum electrolyte values,anion gap and urine pH should be determineted.