Severe growth faltering and persistent hyperchloremic metabolic acidosis as early clues of renal tubular acidosis in a neonate: a case report

Renal tubular acidosis (RTA) often presents as failure to thrive in children. In a resource-limited country, the diagnosis of renal tubular acidosis can be delayed or even missed because of the co-existing high burden of malnutrition. Here we report a case of a neonate/infant who presented with diarrhoea and failure to thrive and subsequently developed septic shock. During the management of the child, proximal renal tubular acidosis was diagnosed based on the persistence of metabolic acidosis with hyperchloremia. Proximal renal tubular acidosis (pRTA) can lead to complications, such as electrolyte disorders, bony deformities. Prompt diagnosis, appropriate treatment, and long-term follow-up are imperative for achieving good outcomes.