Abnormality in A with rickets is: (A) Loss of HCO-3, (B) Loss of Ca++, (C) Lass of K+, (D) All of the above
Answer is A. Proximal or distal renal tubular acidosis(A) are impoant causes of refractory rickets in children.The conditions are characterised by hyperchloremic metabolic acidosis with loss of HCO-3 and normal blood levels of urea and creatinine.Patients with proximal A may show low blood levels of phosphate,aminoaciduria and low molecular weight proteinuria.The use of bicarbonate and phosphate supplementation in proximal A results in healing of rickets. Reference:Essential pediatrics-Ghai,8th edition,page no:115