Key result
Bicarbonate infusion improves refractory acidosis in a patient with DKA and type 2 RTA.
Why the study?
This report highlights the importance of considering renal tubular acidosis in patients with diabetic ketoacidosis who demonstrate resistant acidosis despite adequate management.
Case Report (n=1)
Renal tubular acidosis type 2 should be considered in patients with diabetic ketoacidosis who have refractory acidosis.
Refractory DKA acidosis may signal isolated RTA type 2; case report leaves open bicarbonate's broader role.
Background: Kidneys play a pivotal role in maintaining the acid-base balance along with the respiratory system. Renal tubular acidosis (RTA) type 2 is one of the causes of systemic acidosis caused by impairment of the ability of renal tubules to maintain acid base balance. Aim: This case report highlights the importance of considering renal tubular acidosis for any diabetic ketoacidosis (DKA)patient who demonstrates resistant acidosis despite adequate management. Case Report: Our patient was diagnosed as DKA initially in the emergency department then after admission to ICU we found no response of treatment despite of giving intravenous fluids and treating the cause. Biochemical analysis demonstrated isolated RTA type 2 with high level of bicarbonate combined with normal levels of amino acid, phosphate, uric acid, and glucose in urine. We confirmed RTA type 2 and infusion of bicarbonate was initiated. The condition improved significantly. Conclusion: RTA type2 should be considered in any case of refractory acidosis of DKA patient.
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Farouk Elrashid Mustafa Omer (2025) conducted a case report in Diabetic Ketoacidosis with resistant acidosis (n=1). Bicarbonate infusion was evaluated on Clinical improvement. Bicarbonate infusion significantly improved the condition of a patient with diabetic ketoacidosis and refractory acidosis due to isolated renal tubular acidosis type 2.
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