Rickets is a common condition that affects pediatric patients and is usually secondary to a nutritional deficiency of vitamin D. However, there are also some rare types of rickets that are seen as secondary to renal defects. These types include distal renal tubular acidosis (dRTA), proximal renal tubular acidosis (pRTA), vitamin D-dependent rickets, and hypophosphatemic rickets. Among these causes, hypercalciuria and phosphate wasting are common in distal RTA due to bone resorption, which increases as a buffer against metabolic acidosis. This can result in intractable rickets. Early diagnosis and management are required in these cases. Here, we present the case of a 14-year-old girl who came to us with difficulty walking, failure to thrive, polyuria, hypokalemia, and bone changes. Eventually, the patient was found to have rickets secondary to distal renal tubular acidosis.
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Aye et al. (2024) studied this question.
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