The kidney problems are treated as described above. There is no treatment for the osteopetrosis or cerebral calcification. Type 3 is rarely discussed. Most comparisons of RTA are limited to a comparison of types 1, 2, and 4. Type 4: absolute hypoaldosteronism or aldosterone insensitivity
Type 4 RTA is not actually a tubular disorder at all nor does it have a clinical syndrome similar to the other types of RTA described above. It was included in the classification of renal tubular acidoses as it is associated with a mild (normal anion gap) metabolic acidosis due to a physiological reduction in proximal tubular ammonium excretion (impaired ammoniagenesis), which is secondary to hypoaldosteronism, and results in a decrease in urine buffering capacity. Its cardinal feature is hyperkalemia, and measured urinary acidification is normal, hence it is often called hyperkalemic RTA or tubular hyperkalemia.Causes include:

Aldosterone deficiency (hypoaldosteronism): Primary vs. hyporeninemic (including diabetic nephropathy)
Aldosterone resistanceDrugs: NSAIDs, ACE inhibitors and ARBs, Eplerenone, Spironolactone, Trimethoprim, Pentamidine
Pseudohypoaldosteronism

History
Renal tubular acidosis was first described in 1935 by Lightwood and 1936 by Butler et al. in children. Baines et al. first described it in adults in 1945.Donald L. Lewis postulated the character Tiny Tim, of A Christmas Carol, was suffering from renal tubular acidosis.Researchers published in PLOS ONE in 2009 speculated that the infamously afflicted Charles II of Spain may have suffered from renal tubular acidosis in tandem with combined pituitary hormone deficiency. See also
Charles II of Spain, who is speculated to have suffered with dRTA
Hyperchloremic acidosis
Hypokalemic acidosis
Lightwood–Albright syndrome

References


== External links ==
Naphazoline/pheniramine, sold under the brand name Naphcon-A among others, is a combination eye drop used to help the symptoms of allergic conjunctivitis such as from hay fever. It contains naphazoline and pheniramine. It is used as an eye drop. Use is not recommended for more than three days.Side effects may include allergic reactions, eye pain, and dilated pupils. It is unclear if use in pregnancy is safe. Nephazoline works by resulting in constriction of blood vessels thus decreasing redness while pheniramine works by blocking the effects of histamine to stop itching.The combination was approved for medical use in the United States in 1994. It is available over the counter. In 2017, it was the 203rd most commonly prescribed medication in the United States, with more than two million prescriptions. Medical use
It is administered topically with one to two drops applied to the affected eye(s) up to four times daily. Adverse effects
Pupils may become enlarged temporarily
Overuse may cause more redness
Those with heart disease, high blood pressure, narrow angle glaucoma or who have urination trouble are discouraged from using the product
It is recommended to remove contact lenses before use. Use with contact lenses can lead to reduced oxygenation of the underlying cornea
If infants or children accidentally ingest the drops, it may lead to coma and significant reduction in body temperature. If such ingestion occurs, immediately calling a poison control center is recommended

References
External links
"Naphazoline hydrochloride mixture with pheniramine maleate". Drug Information Portal. U.S. National Library of Medicine.