Renal calcification in children with renal tubular acidosis: What a paediatrician ‎should ‎know‎

Abstract

Renal tubular acidosis (RTA) can lead to renal calcification in children, which can cause various complications and impair renal function. This review provides pediatricians with a comprehensive understanding of the relationship between RTA and renal calcification, highlighting essential aspects for clinical management. The article analyzed relevant studies to explore the prevalence, risk factors, underlying mechanisms, and clinical implications of renal calcification in children with RTA. Results show that distal RTA (type 1) is particularly associated with nephrocalcinosis, which presents a higher risk of renal calcification. However, there are limitations to the existing literature, including a small number of studies, heterogeneity in methodologies, and potential publication bias. Longitudinal data and control groups are also lacking, which limits our understanding of long-term outcomes and optimal management strategies for children with RTA and renal calcification. Pediatricians play a crucial role in the early diagnosis and management of RTA to mitigate the risk of renal calcification and associated complications. In addition, alkaline therapy remains a cornerstone in the treatment of RTA, aimed at correcting the acid-base imbalance and reducing the formation of kidney stones. Therefore, early diagnosis and appropriate therapeutic interventions are paramount in preventing and managing renal calcification to preserve renal function and improve long-term outcomes for affected children. Further research with larger sample sizes and rigorous methodologies is needed to optimize the clinical approach to renal calcification in the context of RTA in the pediatric population.

Keywords: Renal tubular acidosis; Nephrocalcinosis; Renal calcification; Hypercalciuria; Kidney stones; Metabolic acidosis; Children

Core Tip: Children with renal tubular acidosis (RTA) may develop renal calcification, leading to complications and negatively affecting kidney function. This comprehensive review aims to provide pediatricians with a better understanding of the connection between RTA and renal calcification, emphasizing key aspects of clinical management. Relevant studies were analyzed to examine the prevalence, risk factors, underlying mechanisms, and clinical implications of renal calcification in children with RTA. Nephrocalcinosis in type 1 RTA is mainly associated with a higher risk of renal calcification. Further research with larger sample sizes and rigorous methodologies is necessary to improve our understanding of RTA-related renal calcification.