Distal renal tubular acidosis (dRTA) is a kidney disorder that can be inherited (primary dRTA) or be caused by another disorder or medication (secondary dRTA). Your healthcare team will work closely with you to help manage your disease, provide educational information and teach you about living with your disease. This can include primary dRTA or another disease that is a possible cause of secondary dRTA. Your healthcare team will coordinate the necessary medical check-ups and develop an individualized treatment plan. However, much of your day-to-day care is up to you. This is when self-management, or self-care, becomes an important part of your healthcare. You can make choices that will have a positive effect on your health. Important steps towards making positive choices and managing your health include:
- Follow your treatment plan or schedule
- Take care to attend all medical appointments
- Make a list of your medications and take them as prescribed
- Watch for signs, symptoms or changes in your health. Report any sudden changes in symptoms to your healthcare team
- Make healthy food and lifestyle choices and follow any special dietary recommendations from your healthcare team
- Maintain a good exercise program agreed upon by you and your healthcare team
Following your treatment plan
It is important that you follow your treatment plan to help keep you as healthy as possible. The treatment plan often includes dietary recommendations and specific medications. Some individuals find that keeping a log book (whether written or electronic), of their medications, lab results, appointments or any other important information about their health can make a big difference. You can take the book along to your appointments so you can discuss changes and/or new instructions with your healthcare team. You can speak to a healthcare professional about access to your lab results.
Speak with your healthcare team if you feel overwhelmed or unable to manage one or more aspects of your care plan. You should ask questions when you are not sure about something, especially if the information is too technical or medical. Your doctor, nurse or other member of the healthcare can explain things it help better understand the information. Don’t forget that you can ask friends or loved ones for help if necessary and have them attend appointments with you to listen to what a healthcare professional says.
Taking your medications
Remembering to take your medications every day and at the right time is an important step in managing dRTA. Here are some helpful tips to taking your medication(s):
- Get into the habit of taking your medication(s) as prescribed; whether this be when you first wake up, at mealtimes and/or bedtime
- A routine can help you stay on track
- Create a visual schedule to hang up on your wall or set alarms on your Smartphone to remind you when to take your medication. Check to see if your Smartphone has an app that helps you keep track of your medication schedule
- A pillbox can help sort and organize your medications
- Always keep an updated list of all the medications you take, including over-the-counter medications and herbal supplements
Watching for symptoms or changes in health
It is important to be aware of the signs and symptoms linked with dRTA and to contact a healthcare professional if you or a loved one experience symptoms or if you notice a sudden change in symptoms. Possible signs and symptoms indicating an issue with those living with dRTA include:
- Confusion or decreased alertness
- Excess fatigue
- Muscle weakness
- Breathing difficulties
- Increased heart rate or irregular heartbeat
- Muscle cramps and pain
- Pain in the back, sides and/or abdomen (known as flank pain)
- Bone pain
- Less urine output
- Difficulty hearing
Symptoms that may require immediate medical attention include an irregular heartbeat, breathing difficulties, or severe weakness and fatigue.
Making healthy lifestyle choices
Making healthy lifestyle choices is important for your kidney health and overall health, as the two are interconnected. Healthy lifestyle changes can include:
- Maintaining a healthy weight and losing extra weight if you are overweight
- Reducing the amount of salt in your diet to help control blood pressure or help reduce the risk for developing kidney stones
- Speaking to your healthcare team before taking any new medications, supplements, or herbal remedies. This also includes some common over-the-counter medications like ibuprofen or naproxen as these medications may be harmful to your kidneys
- Stop smoking if you smoke. Smoking is harmful to many organs, including the lungs, heart, and kidneys
- Increasing your physical activity. Together with your healthcare team you can identify an exercise program that is right for you
- Locating a dietitian. A dietician is a healthcare professional specializing in helping develop a diet plan that’s right for you.
Exercise and physical activity
The benefits of an exercise program can’t be overstated. An exercise program approved by your healthcare team offers numerous health benefits and can help increase strength and endurance, prevent fatigue, reduce stress, and increase the overall quality of day-to-day living. Before beginning an exercise program, it is important to consult a healthcare professional and remember there is a fine line between "doing" and "overdoing." An exercise program should be planned to meet your special needs.
Whether you are just getting started or maintaining an exercise routine, staying motivated and including more physical activity as part of regular routine is very important. There are a number of ways to help you stay with your exercise routine, including the following:
- Avoid injuries by easing into a new routine, and stretching before and after exercising
- Exercise while watching TV (stretching, light treadmill, exercise bike, etc.)
- Fit exercise and physical activity into your home routine
- Try to fit more physical activity into your work and commute. Incorporate more walking and into your commute, walk during your lunch hour, or take the stairs for starters
- Find an exercise buddy that will help motivate you on days when it might be easy to just say you’ll do it tomorrow
Diet and Nutrition
dRTA can cause blood to have too much acid (acidosis) and also raise the risk of developing kidney stones. You may be asked to take steps to help lower the acid levels in the body or prevent calcium-based kidney stones from forming by avoiding consumption of too much animal protein, which has been shown to increase the production of acid in the body. Eating more fruits and vegetables can help lower the amount of acid produced in the body. If you have a kidney stone, you may also be asked to drink more water in a given day. Eating less salt (sodium) might also be needed, since sodium can increase levels of substances in the blood and urine, such as calcium, that cause stones to form in people with dRTA. You should speak with a dietitian or other healthcare professional about your diet and nutritional needs based on your medical situation.
You should ask a healthcare professional about meeting with a Registered Dietitian with special training in kidney disease. A dietitian can teach you to make the best food choices based on your lab tests results and personal lifestyle. Meeting with a dietitian is a covered service by Medicare. The service may also be a covered benefit by other types of insurance. You may need to call your insurance provider to find out if meeting with a dietitian is covered by your plan.
There is not one eating plan that is right for everyone. What you can or cannot eat may change over time depending on how much kidney function you have and other factors.
dRTA can have a long-term impact so it’s important for people living with this condition to remain active participants in their healthcare, keep up with their medical appointments, take their medications as directed, and stay with the treatment plan as recommended by their healthcare team.