Eagle_303 wrote:nightflight1945 wrote:
RTA type 2 : There is defect in absorption of Ca++ and PO4 from prox tubule -----------> Ca and PO4 deficiency in body ---------> Rickets or Osteomalacia
RTA type 1 : The change in urinary PH account for preparation of the environment suitable for formation of Ca stones
Brother nightflight! RTA type 2 primary defect is only HCO3 rebabsorption .There is no defect in PO4 reabsorption. Hypercalciuria is not due primarily due to defective reabsorption from the renal tubules.It is due to hyperfiltration because it is has been primarily removed from the bones in the form of Ca Carbonate in an attempt to counteract chronic acidosis. Again stone formation in these acidotic conditions probably not because of pH change (pH is alkaline in type 1) rather due to Hypocitraturia which occurs in chronic acidotic conditions. Due to some unknown reasons nephrocalcinosis and stone formation is much increased in type I RTA If you disagree most welcome to make correction. Best of luck
1-RTA 2 in many cases is a part of fanconi syndrome!!also the mechanism u mentioned can be a reason!
2-alkaline urine is a good environment for Ca deposition although decresed Cytrate also helps!
|
| Eagle_303
Forum Guru
Topics: 77
Posts: 655
|
yes brother RTA 2 does occur in Fanconi syndrome ,but it does not mean every RTA 2 is Fanconi syndrome.
In RTA 2 = Only HCO3 defect
In Fanconi Syndrome = Whol PCT ( proximal Convoluted tubule ) is affected.leading to Bicarbonaturia ,phosphaturia ,aminoacid uria ,Glucosuria , So RTA 2 is a component of Fanconi.In this case we use a collective term Fanconi syndrome.
But when say RTA 2 it means HCO3 reabsorption defect primarily. If there is other pathophysiological change it is secondary.
Only stones which are precipitated by alkaline urine or Stuvite stone.These are invariably due to infection.As far as I have gone through ,no source labels formation of struvite stone 's eitiology as RTA -1 .Every source say infection with urea splitting organism becaue NH3 is produced from Urea which is a component of these Struvite stones.
Please do corret it it is not right version.
thanks for your time.
|
| nightflight1945
banned
Topics: 32
Posts: 920
|
Also Ca stones are formed with higher frequency in Alkaline Urine ,
Sorry but don't have enough time to find a referrence
|
| nyimalay
Forum Elite
Topics: 11
Posts: 299
|
great discussion !
|
|
| |
| | | | | 
Similar forum topics