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Open ittype 4 (hyperkalemic distal) RTA typically present with hyperkalemia, a normal anion gap metabolic acidosis, and impaired urine acidification, but with the ability to maintain the urine pH to <5.5. The specific cause can be differentiated by measurement of plasma renin activity, serum aldosterone, and serum cortisol. Initial treatment includes correction of the underlying causOriginal toplevel document (pdf)
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ELBOMBARDO - (no access) - MKSAP_17.pdf, p3384