Talk:Renal tubular acidosis

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Good article Renal tubular acidosis has been listed as one of the Natural sciences good articles under the good article criteria. If you can improve it further, please do. If it no longer meets these criteria, you can delist it, or ask for a reassessment.
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Contents

[edit] Work in Progress

I know it's short, but it's only a start...Felix-felix 17:15, 23 November 2006 (UTC)

You did a fantastic job - excellent references! -- Serephine ♠ talk - 02:54, 25 April 2007 (UTC)

[edit] Any proposed changes?

Suggestions/orders here please...FelixFelix talk 16:08, 6 March 2007 (UTC)

Who made the type I-IV classification? JFW | T@lk 20:22, 6 March 2007 (UTC)
Not a clue, although I always thought it was gradually added to rather than created denovo. I will try and find out.FelixFelix talk 20:27, 6 March 2007 (UTC)

[edit] Failed "good article" nomination

This article failed good article nomination. This is how the article, as of May 9, 2007, compares against the six good article criteria:

1. Well written?: Pass
2. Factually accurate?: Fail Many statements in the first two sections are unsourced
3. Broad in coverage?: Pass
4. Neutral point of view?: Pass
5. Article stability? Pass
6. Images?: Satisfactory Image descriptions could be more detailed, including where they came from

When these issues are addressed, the article can be resubmitted for consideration. If you feel that this review is in error, feel free to take it to a GA review. Thank you for your work so far. — The Sunshine Man 11:43, 9 May 2007 (UTC)

OK, for the record, I'm a bit puzzled by the review above, but now section one has 14 references, and section 2 has 12 references, the entire article has 31, which seems almost reference heavy to me. I've added another image, and slightly expanded one of the image source descriptions, but the 2 original pics are both donated by me into the public realm, as a cursory glance at the picture pages will show-so I'm puzzled by this comment also, but have endeavored to answer the reviewer's criticism.So, I'm going to resumit it.FelixFelix talk 09:20, 15 May 2007 (UTC)

[edit] Type 4 RTA confusion

I have to admit, I've never totally understood the garden variety Type 4 RTA that comes from hyporeninemic hypoaldosteronism. Why is it that diabetics w/ sCr of 2mg/dl don't have appropriate kaliuresis? Shouldn't the hyperkalemia directly stimulate adrenal release of aldo? When treating with fludrocortisone, one has to give supraphysiologic doses to manage the K. I've always assumed the diabetics (and those with obstructive uropathy) actually *do* have a specific tubular defect that reduces their responsiveness to aldosterone out of proportion to their reduction of GFR. Of course, I can't find anything in the literature to back up my supposition. Felix, do you work with Fiona? Would she have any thoughts about this? Dan Levy 15:39, 23 May 2007 (UTC)

I agree, and I've got to say that if I had my way, the numerical nomenclature would be scrapped, doing away with both types 3 and 4, which simply cause confusion. As for the mechanism of 'type 4', I'd agreee that the whole thing (like much classical renal tubular physiology in my opinion) is all a bit mystical and simplified-but my understanding is something along the lines that, hyporesponsiveness to aldosterone (for whatever reason) leads to a relative failure of recruitment of ENaC in the distal principle cells, and thus less Na reclamation, leading to a loss of the subsequent lumen electronegativity (which is generated from slower Cl- transport), which drives both H+ and K+ secretion into the distal lumen. The reason why there is hyporesponsiveness to aldo in (usually diabetic) pts with CKD seems much less clear, and I for one haven't heard a convincing explanation. I don't work with Fiona (I presume you mean Fiona Karet), I've worked with the UCL group, who probably have more physiological experience than the Cambridge group, who are strong in genetics and cell transport work. I'll ask around, but people's eyes tend to glaze over a bit when you mention type 4...FelixFelix talk 11:29, 25 May 2007 (UTC)

Eyes glazed over....yes I've seen that one. Thanks. Dan Levy 15:58, 25 May 2007 (UTC)

[edit] Reworking Introduction

I tried to make the introduction a little more user friendly to the layperson. Hopefully, it's not to wordy. I should say that (IMHO) I do not see the term acidosis as a misnomer in any way: A mild acidosis can occur that is buffered or otherwise compensated for, preventing significant acidemia. I guess that the exception is an incomplete RTA, which may not really cause an acidosis.....but this is discussed in the dRTA section. Dan Levy 22:11, 26 May 2007 (UTC)

[edit] Successful good article nomination

I am glad to say that this article which was nominated for good article status has succeeded. This is how the article, as of May 27, 2007, compares against the six good article criteria:

1. Well written?: Acceptable, but consider rewording to make it easier to understand for a layman, and clarifying the causes of the type of RTA, and its symptoms. There are a few badly-placed citations. Inline citations go immediately after the nearest punctuation, not before.
2. Factually accurate?: Looks good.
3. Broad in coverage?: Yes. How common is RTA?
4. Neutral point of view?: Yes.
5. Article stability? Yes.
6. Images?: Good.

If you feel that this review is in error, feel free to take it to a GA review. Thank you to all of the editors who worked hard to bring it to this status.. — Carson 20:02, 27 May 2007 (UTC)

All of the references are sorted out with respect to punctuation, finally.FelixFelix talk 20:09, 14 September 2007 (UTC)

[edit] Very well written article indeed!

This is one of the better written articles in the medical sciences section of Wikipedia! Such articles increase readership amongst the medical fraternity, who can review it as a ready reckoner prior to exams and reviews! Better listing of references would help, but I am not complaining! Looking forward to more such articles from the author!

Regards,

A fellow doctor! —Preceding unsigned comment added by 122.162.87.243 (talk) 20:22, August 30, 2007 (UTC)

Yes thankyou FelixFelix this is a very well written article and one of the few on Wikipedia that I have read understanding the credibility of the material. Thanks - this article has helped me understand RTA, which is a very difficult concept!


A fellow physician Logical paradox (talk) 12:17, 10 April 2008 (UTC)

"Distal RTA (dRTA) is the classical form of RTA, being the first described. *It has a number of causes which cause a common underlying problem,* which is a failure of acid secretion by the alpha intercalated cells of the cortical collecting duct of the distal nephron. "

The starred clause is not well-written... the "which" should be changed to "that", at a minimum. To be honest, I'm not sure what it's saying.. do all of the causes of dRTA result in failure of acid secretion? Or is there an underlying problem, failure of acid secretion, which causes dRTA in a number of different ways? I'm sure I could read the rest of the paragraph and piece this together, I just wanted to say it's not very clear as-is. (dRTA has a number of causes that cause a common problem.... what?!)Dr.queso (talk) 14:43, 12 June 2008 (UTC)