A 38-year-old with Sjögren syndrome has recurrent calcium-phosphate stones, potassium 2.9 mmol/L, bicarbonate 16 mmol/L, a normal anion gap and urine

Question

A 38-year-old with Sjögren syndrome has recurrent calcium-phosphate stones, potassium 2.9 mmol/L, bicarbonate 16 mmol/L, a normal anion gap and urine pH 6.7 during systemic acidosis. Which disorder best explains the findings?

Accepted Answer

Distal renal tubular acidosis with impaired urinary acidification

Answer

Ethylene-glycol toxicity causing a high-anion-gap acidosis

Answer

Type 4 renal tubular acidosis from hypoaldosteronism

Answer

Chronic diarrhea with an inappropriately alkaline kidney response

Answer

Proximal renal tubular acidosis with appropriate distal acidification

Normal anion-gap metabolic acidosis — RCPSC IM MCQ

A 38-year-old with Sjögren syndrome has recurrent calcium-phosphate stones, potassium 2.9 mmol/L, bicarbonate 16 mmol/L, a normal anion gap and urine pH 6.7 during systemic acidosis. Which disorder best explains the findings?