II. Pathophysiology

  1. Kidney unable to excrete daily acid load
  2. Results in Metabolic Acidosis

IV. Labs

  1. Chemistry Panel
    1. Serum Chloride elevated
    2. Serum bicarbonate decreased
    3. Anion Gap normal
  2. Arterial Blood Gas (ABG)
    1. Non-Anion Gap Metabolic Acidosis
  3. Fractional Excretion of Bicarbonate
    1. FE-HCO3 <5%: Distal RTA
    2. FE-HCO3 >15%: Proximal RTA
      1. Assumes serum bicarbonate >20 meq/L

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