Talk:Renal tubular acidosis

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 26 August 2019 and 15 November 2019. Further details are available on the course page. Student editor(s): AmyMarshallRN, Nt4993, Sierrahouston, Kjsem3.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 08:01, 17 January 2022 (UTC)

Work in Progress
I know it's short, but it's only a start...Felix-felix 17:15, 23 November 2006 (UTC)
 * You did a fantastic job - excellent references! --  Serephine   ♠   talk   - 02:54, 25 April 2007 (UTC)

Any proposed changes?
Suggestions/orders here please...  Felix Felix talk 16:08, 6 March 2007 (UTC)


 * Who made the type I-IV classification? JFW | T@lk  20:22, 6 March 2007 (UTC)
 * Not a clue, although I always thought it was gradually added to rather than created denovo. I will try and find out.  Felix Felix talk 20:27, 6 March 2007 (UTC)


 * Minor issue- the Type I RTA section says "This failure of acid secretion may be due to a number of causes, and it leads to an inability to acidify the urine to a pH of less than 5.3." Granted, it may seem obvious to many people that ph 5.3 must be either a normal or low end value for urine pH, but to others it may seem an arbitrary value. In other words, why do we care that we can't acidify the pH to less than that particular value of 5.3? I don't know a clear and concise way to state this, and I certainly think the current version is better than my earlier revision, but I did want to throw that out there in case anyone had any suggestions (and to gauge if I'm the only one who thinks this might be problematic.) If it comes down to it, I'd say describing the pH value in question as "normal" would be more practical than to describe it as "5.3" Dr.queso (talk) 18:01, 3 January 2009 (UTC)

Failed "good article" nomination
This article failed good article nomination. This is how the article, as of May 9, 2007, compares against the six good article criteria:


 * 1. Well written?: Pass
 * 2. Factually accurate?: Fail Many statements in the first two sections are unsourced
 * 3. Broad in coverage?: Pass
 * 4. Neutral point of view?: Pass
 * 5. Article stability? Pass
 * 6. Images?: Satisfactory Image descriptions could be more detailed, including where they came from

When these issues are addressed, the article can be resubmitted for consideration. If you feel that this review is in error, feel free to take it to a GA review. Thank you for your work so far. — The Sunshine Man 11:43, 9 May 2007 (UTC)


 * OK, for the record, I'm a bit puzzled by the review above, but now section one has 14 references, and section 2 has 12 references, the entire article has 31, which seems almost reference heavy to me. I've added another image, and slightly expanded one of the image source descriptions, but the 2 original pics are both donated by me into the public realm, as a cursory glance at the picture pages will show-so I'm puzzled by this comment also, but have endeavored to answer the reviewer's criticism.So, I'm going to resumit it.  Felix Felix talk 09:20, 15 May 2007 (UTC)

Type 4 RTA confusion
I have to admit, I've never totally understood the garden variety Type 4 RTA that comes from hyporeninemic hypoaldosteronism. Why is it that diabetics w/ sCr of 2mg/dl don't have appropriate kaliuresis? Shouldn't the hyperkalemia directly stimulate adrenal release of aldo? When treating with fludrocortisone, one has to give supraphysiologic doses to manage the K. I've always assumed the diabetics (and those with obstructive uropathy) actually *do* have a specific tubular defect that reduces their responsiveness to aldosterone out of proportion to their reduction of GFR. Of course, I can't find anything in the literature to back up my supposition. Felix, do you work with Fiona? Would she have any thoughts about this? Dan Levy 15:39, 23 May 2007 (UTC)


 * I agree, and I've got to say that if I had my way, the numerical nomenclature would be scrapped, doing away with both types 3 and 4, which simply cause confusion. As for the mechanism of 'type 4', I'd agreee that the whole thing (like much classical renal tubular physiology in my opinion) is all a bit mystical and simplified-but my understanding is something along the lines that, hyporesponsiveness to aldosterone (for whatever reason) leads to a relative failure of recruitment of ENaC in the distal principle cells, and thus less Na reclamation, leading to a loss of the subsequent lumen electronegativity (which is generated from slower Cl- transport), which drives both H+ and K+ secretion into the distal lumen. The reason why there is hyporesponsiveness to aldo in (usually diabetic) pts with CKD seems much less clear, and I for one haven't heard a convincing explanation. I don't work with Fiona (I presume you mean Fiona Karet), I've worked with the UCL group, who probably have more physiological experience than the Cambridge group, who are strong in genetics and cell transport work. I'll ask around, but people's eyes tend to glaze over a bit when you mention type 4...  Felix Felix talk 11:29, 25 May 2007 (UTC)

Eyes glazed over....yes I've seen that one. Thanks. Dan Levy 15:58, 25 May 2007 (UTC)

Reworking Introduction
I tried to make the introduction a little more user friendly to the layperson. Hopefully, it's not to wordy. I should say that (IMHO) I do not see the term acidosis as a misnomer in any way: A mild acidosis can occur that is buffered or otherwise compensated for, preventing significant acidemia. I guess that the exception is an incomplete RTA, which may not really cause an acidosis.....but this is discussed in the dRTA section. Dan Levy 22:11, 26 May 2007 (UTC)

Successful good article nomination
I am glad to say that this article which was nominated for good article status has succeeded. This is how the article, as of May 27, 2007, compares against the six good article criteria:


 * 1. Well written?: Acceptable, but consider rewording to make it easier to understand for a layman, and clarifying the causes of the type of RTA, and its symptoms. There are a few badly-placed citations. Inline citations go immediately after the nearest punctuation, not before.
 * 2. Factually accurate?: Looks good.
 * 3. Broad in coverage?: Yes. How common is RTA?
 * 4. Neutral point of view?: Yes.
 * 5. Article stability? Yes.
 * 6. Images?: Good.

If you feel that this review is in error, feel free to take it to a GA review. Thank you to all of the editors who worked hard to bring it to this status.. — Carson 20:02, 27 May 2007 (UTC)


 * All of the references are sorted out with respect to punctuation, finally.  Felix Felix talk 20:09, 14 September 2007 (UTC)

Very well written article indeed!
This is one of the better written articles in the medical sciences section of Wikipedia! Such articles increase readership amongst the medical fraternity, who can review it as a ready reckoner prior to exams and reviews! Better listing of references would help, but I am not complaining! Looking forward to more such articles from the author!

Regards,

A fellow doctor! —Preceding unsigned comment added by 122.162.87.243 (talk) 20:22, August 30, 2007 (UTC)

Yes thankyou FelixFelix this is a very well written article and one of the few on Wikipedia that I have read understanding the credibility of the material. Thanks - this article has helped me understand RTA, which is a very difficult concept!

A fellow physician Logical paradox (talk) 12:17, 10 April 2008 (UTC)

"Distal RTA (dRTA) is the classical form of RTA, being the first described. *It has a number of causes which cause a common underlying problem,* which is a failure of acid secretion by the alpha intercalated cells of the cortical collecting duct of the distal nephron. "

The starred clause is not well-written... the "which" should be changed to "that", at a minimum. To be honest, I'm not sure what it's saying.. do all of the causes of dRTA result in failure of acid secretion? Or is there an underlying problem, failure of acid secretion, which causes dRTA in a number of different ways? I'm sure I could read the rest of the paragraph and piece this together, I just wanted to say it's not very clear as-is. (dRTA has a number of causes that cause a common problem.... what?!)Dr.queso (talk) 14:43, 12 June 2008 (UTC)

You might try just reading the rest of the sentence that tells you that the common problem, is "a failure of acid secretion by the alpha intercalated cells of the cortical collecting duct of the distal nephron." Quite simple really. If you don't like the phrasing, you are at total liberty to edit it. —Preceding unsigned comment added by 82.246.159.209 (talk) 15:35, 17 June 2008 (UTC)

"It [the problem] has a number of causes which cause a common problem." You don't see the problem? I suggest stating what the "common underlying problem" is-- failure of acid secretion by the alpha intercalated cells of the cortical collecting duct of the distal nephron." And instead of describing it as the "common underlying problem," since this section is entitled "type I-Distal RTA," it might be better to start with a description of type I-Distal RTA (failure of acid secretion), and then say "type I-Distal RTA has a number of causes" or, if you prefer, "failure of acid secretion in the distal nephron can be caused in a number of ways." If there is no objection to the suggestions, I will edit the article at a later time.Dr.queso (talk) 02:37, 14 July 2008 (UTC)

Epidemiology
How common are these conditions?-- Doc James (talk · contribs · email) 01:43, 21 May 2009 (UTC) Thought to be rare, but no formal epidemiology available-good luck if you can find a good source about it!  Felix Felix talk 18:31, 17 October 2009 (UTC)


 * This needs to be added if that is the case. Doc James (talk · contribs · email) 08:22, 25 October 2009 (UTC)

Four diseases on one page
This page seems to deal with four different conditions. Each should probably have there own page with a summary presented here.-- Doc James (talk · contribs · email) 09:46, 9 June 2009 (UTC) No, I disagree, these related syndromes are always detailed together in the text books, and its useful to have them on one page as the concepts involved are notoriously tricky. If the page was much bigger, you might have a point-but it's a good size.  Felix Felix talk 08:58, 26 June 2009 (UTC)

What happened?
The article got gutted, with no discussion! I appreciate that user:docjames idly talked about an article split 3 years ago, but I thought that we'd agreed not to do that (or that was what I thought anyway...!). All my carefully formatted citations gone, and the different types all on different pages!!-I really think this makes this traditionally very confusing subject harder, not easier for the interested reader to understand. I propose a merge, toot sweet, as they say, but lets have a chinwag and achieve consensus. Cheers  Felix Felix talk 09:39, 17 July 2011 (UTC)
 * Felix-felix, other than Johann Hari, you haven't edited an article since July of 2009, and you haven't edited the talk page of a medical article since October of 2009. You aren't an active participant on Wikipedia, so you shouldn't expect the content here to reflect your values and priorities, especially when they conflict with those of editors who are still doing the work, such as Jmh649, who opposed you above. --Arcadian (talk) 13:20, 17 July 2011 (UTC)
 * That's not a very constructive response-my lack of consistency in editing is surely neither here nor there-should we not be discussing the article? I reckon your (unbilateral) splitting of it makes it less clear-a real issue for this difficult topic. I don't expect this article to reflect my values (whatever that means) and my priority is to make this article a good one (a priority that I believe my contribution history reflects). So shall we discuss the article?  Felix Felix talk 23:05, 17 July 2011 (UTC)
 * Make your case for a merge. --Arcadian (talk) 00:21, 18 July 2011 (UTC)

Error, but I don't know how to change it w.o. causing format probs.
In the bullet point list for "type 1 distal" it says hypERkalemia, but it should say hypOkalemia. — Preceding unsigned comment added by 108.54.17.159 (talk) 03:00, 21 June 2014 (UTC)