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Kidney function in patients with primary distal renal tubular acidosis

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Abstract

Background

Recent reports indicate that chronic reduction of glomerular filtration rate (GFR) is common in patients with distal renal tubular acidosis (DRTA). Factors responsible for decreased GFR need clarification.

Methods

We reviewed records of 25 patients with genetically confirmed DRTA included in the RenalTube database. Patients < 18 years at diagnosis and having at least one annual follow-up were selected and classified in two groups according to GFR ≥ 90 (normal GFR) or < 90 mL/min/1.73 m2 (low GFR) after median follow-up of 8.8 years.

Results

Eighteen and seven patients had normal and low GFR (X ± SEM, 121.16 ± 28.87 and 71.80 ± 10.60 mL/min/1.73 m2, respectively, p < 0.01). At diagnosis, these 2 subgroups did not differ in sex, age, underlying mutated gene, GFR, height SDS, or percentage of ultrasound nephrocalcinosis. Serum creatinine (SCr) was different but likely due to median ages of presentation being 0.6 and 4.0 in normal and low GFR patients, respectively. On the last recorded visit, no differences between both groups were found in serum bicarbonate, serum potassium, or alkali dosage. Height SDS of patients with normal GFR was − 0.15 ± 0.47 whereas it was − 1.06 ± 0.60 in the low GFR group (p = 0.27). Interestingly, 23% of the whole group had low birth weight (LBW; < 2500 g), equating to 20% and 29% in the normal and low GFR patients, respectively (p = 0.65).

Conclusions

Our findings confirm the risk of kidney function reduction in patients with DRTA of pediatric age onset, suggesting that low GFR is related with less favorable growth outcome and discloses the high frequency of LBW in primary DRTA, a hitherto unrecognized feature.

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Availability of data and material

Data were collected from the RenalTube database and were recorded after previous informed consent.

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Acknowledgements

The authors want to thank the rest of our colleagues who integrate the RenalTube Group from Hospital Universitario Central de Asturias (Oviedo), from Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife), from Hospital Universitario de Cruces (Basurto), and from Hospital Universitario Valld’Hebrón (Barcelona). We also want to thank all the physicians who have contributed to the study entering the patients in the database, especially Dr. Gema Ariceta, Dr. Cristina Aparicio López, and Dr. Ainhoa Iceta.

Funding

This study was supported by Fundación Nutrición y Crecimiento, by grants PI17/01745 (Plan Estatal I + D + I 2017–2020) from the Instituto de Salud Carlos III (Madrid, Spain) and GRUPIN14–20 from Fondos Europeos de Desarrollo Regional (FEDER), and by Fundación para la Investigación Biomédica en Asturias (FINBA).

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Author notes

  1. Jessica M. Forero-Delgadillo and Helena Gil-Peña contributed equally to this work.

Authors and Affiliations

  1. Valle de Lili Foundation, Faculty of Health Sciences, Icesi University, Cali, Colombia

    Jessica M. Forero-Delgadillo

  2. Hospital Universitario Central de Asturias, Avd. Roma SN, 33011, Oviedo, Spain

    Helena Gil-Peña & Fernando Santos

  3. Hospital Universitario de Cruces, Baracaldo, Bilbao, Spain

    Marta Alonso-Varela

  4. University of Oviedo, Oviedo, Spain

    Marta Alonso-Varela & Fernando Santos

Authors
  1. Jessica M. Forero-Delgadillo
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  2. Helena Gil-Peña
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  3. Marta Alonso-Varela
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  4. Fernando Santos
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Consortia

RenalTube Group

Contributions

JMFD and HGP contributed equally to data collection and analysis. JMFD, MAV, and HGP prepared the first draft of the report. FS came up with the original idea, wrote the final version of the article, and supervised all the work.

Corresponding author

Correspondence to Fernando Santos.

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The authors declare no competing interests.

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Forero-Delgadillo, J.M., Gil-Peña, H., Alonso-Varela, M. et al. Kidney function in patients with primary distal renal tubular acidosis. Pediatr Nephrol 36, 1931–1935 (2021). https://doi.org/10.1007/s00467-021-05068-x

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  • DOI: https://doi.org/10.1007/s00467-021-05068-x

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