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The Curbsiders Internal Medicine Podcast

Supercharge your learning as these board-certified Internists interview the experts to bring you clinical pearls, practice changing knowledge, and a healthy dose of humor. 

Jul 16, 2018

Renal tubular acidosis aka RTA deconstructed by @Kidney_Boy, Joel Topf MD, Chief of Nephrology at Kashlak Memorial Hospital. We review the three buckets of non gap metabolic acidosis, normal renal physiology & acid base handling, points of failure in RTA, complications and treatment of RTA. Check out Dr Topf’s awesome slides on renal tubular acidosis at .

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  • Written by: Matthew Watto MD and Joel Topf MD
  • Produced by: Matthew Watto MD
  • Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
  • Guest: Joel Topf MD

Time Stamps

  • 00:00 Announcements
  • 01:02 Disclaimer
  • 01:40 Intro and guest bio
  • 04:00 Joel’s one liner
  • 06:05 Joel’s “favorite failure”
  • 11:45 Paul shares a failure
  • 13:20 Tweetorials
  • 16:39 Clinical case of non gap metabolic acidosis
  • 18:06 Three buckets of NAGMA and GI losses
  • 21:02 Chloride intoxication and normal saline
  • 25:14 Renal tubular acidosis and normal role of kidney in acid base
  • 35:03 Proximal (type 2) RTA
  • 40:33 Cases of proximal RTA
  • 43:38 Distal (type 1) RTA
  • 53:15 Bicarbonate dosing and titration
  • 55:28 Type 4 RTA (hypoaldosteronism)
  • 62:09 Urinary anion gap and ammonium
  • 67:26 Replacing GI losses of bicarbonate
  • 70:25 Joel reviews quick cases of RTA and NAGMA
  • 74:49 Outro 

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