MediAI

  Renal Tubular Acidosis (RTA) is a disorder resulting from the kidney's impaired acid-base regulation, leading to an imbalance in the body's pH level. Normally, the kidneys help maintain the body's acid-base balance by excreting excess acid in the urine while retaining bicarbonate, which acts as a buffer against acidity. There are several types of RTA , each with its own underlying cause. This column examines a case of a 38-year-old male patient referred for the evaluation of Distal Renal Tubular Acidosis (Type 1 RTA) . Clinical Case Summary A 38-year-old male was referred for evaluation of distal renal tubular acidosis . Laboratory evaluation results were as follows: Serum Potassium : 3.3 mmol/L( Hypokalemia ) Bicarbonate (HCO 3 ) : 16 mmol/L( Metabolic Acidosis ) Creatinine (Cr) : 3.0 mg/dL(265 umol/L)( Impaired Renal Function ) Estimated Glomerular Filtration Rate (eGFR) : 25   ml/min/1.73m 2 ( Chronic Kidney Disease Stage 4 ) Calcium (Ca) : 9.3...

Introduction Encapsulating peritoneal sclerosis (EPS) is a rare but life-threatening complication primarily associated with long-term peritoneal dialysis (PD) in patients with end-stage kidney disease (ESKD). Although uncommon, EPS carries a high morbidity and mortality, often due to progressive intestinal obstruction and malnutrition. Characterized by extensive fibrosis and calcification of the peritoneum, EPS forms a dense “cocoon” encasing the bowel loops, leading to encapsulation, tethering, and eventual obstruction. This article explores the pathophysiology, epidemiology, clinical features, imaging findings, differential diagnosis, treatment strategies, and prognosis of EPS, illustrated with imaging examples, and concludes with questions for learners. Pathophysiology EPS arises from chronic peritoneal inflammation and fibrosis. The process is believed to be “two-hit”: First Hit – Chronic peritoneal insult Long-term exposure to bio-incompatible PD fluids, rich in glucos...