EXPLORING RENAL TUBULAR ACIDOSIS IN AUTOIMMUNE DISEASES: A CASE-CONTROL STUDY

Abstract

Renal tubular acidosis (RTA), a frequently underdiagnosed renal complication in autoimmune diseases, is marked by impaired acid-base regulation due to tubular dysfunction. This study aimed to investigate the clinical, biochemical, and immunological features of RTA in patients with autoimmune disorders to better understand its pathophysiology and inform treatment strategies. A cohort of autoimmune patients was evaluated for RTA subtypes through arterial blood gas analysis, urine profiling, and inflammatory biomarker assays. Results demonstrated that distal RTA was associated with more profound acidemia and elevated urine pH, whereas proximal RTA exhibited increased urinary bicarbonate wasting. Table-based analysis revealed a strong prevalence of ANA and Anti-SSA antibodies, alongside elevated CRP and IL-6 levels. Symptomatically, fatigue and muscle weakness were the most common complaints. Multivariate logistic regression identified Anti-SSA positivity and low bicarbonate levels as significant predictors of RTA. Treatment responses varied, with immunosuppressive therapy outperforming alkali replacement, especially in distal RTA cases. Nine graphical visualizations further illustrated key trends, including inflammatory profiles, treatment outcomes, and antibody distributions. These findings highlight the need for early diagnostic intervention and immunological assessment to guide personalized treatment strategies. The study concludes that autoimmune-mediated RTA requires a multidimensional diagnostic approach and that immunosuppressive regimens may offer superior renal protection. Further research is needed to refine therapeutic algorithms and reduce long-term renal morbidity in autoimmune populations.