A 45-year-old with primary Sjögren disease develops weakness. Potassium is 2.8 mmol/L, bicarbonate 15 mmol/L, chloride 116 mmol/L, creatinine normal

Question

A 45-year-old with primary Sjögren disease develops weakness. Potassium is 2.8 mmol/L, bicarbonate 15 mmol/L, chloride 116 mmol/L, creatinine normal and urine pH 6.4 despite systemic acidaemia. Which complication best explains the pattern?

Accepted Answer

Distal renal tubular acidosis from tubulointerstitial disease

Answer

Secretory diarrhoea causing appropriate maximal urinary acidification

Answer

Proximal tubular acidosis with universal glycosuria and phosphaturia

Answer

Respiratory alkalosis with compensatory renal bicarbonate loss

Answer

Type 4 renal tubular acidosis caused by hypoaldosteronism

Hepatocellular carcinoma surveillance — RACP Adult Medicine MCQ

A 45-year-old with primary Sjögren disease develops weakness. Potassium is 2.8 mmol/L, bicarbonate 15 mmol/L, chloride 116 mmol/L, creatinine normal and urine pH 6.4 despite systemic acidaemia. Which complication best explains the pattern?