<prompt> All are true about type 1 renal tubular acidosis except:Renal stonesHypokalemiaSodium bicarbonate requirement 4 mgdayUrine pH 5.5  <response>: Ans. c. Sodium bicarbonate requirement Renal Tubular Acidosis Feature Type IDistal Type IIProximal Type IV Normal anion gap Yes Yes Yes Minimum urine pH 5.5deg 5.5deg 5.5 A filtered bicarbonate excreted 10 15 10 Serum potassium Low Low Highdeg Fanconis syndrome No Yesdeg No StonesNephrocalcinosis Yesdeg No No Daily acid excretion Low Normaldeg Low Urinary anion gap Positive Positive Positive Type 1 Distal A In distal A, the kidneys are unable to acidify the urine to pH Treatment Early initiation of alkali replacement at doses equivalent to 1-3 mmolkg per day of bicarbonate in divided doses will usually correct the acidosis, hypokalemia, and hypocitraturia, maintaining growth and preventing bone disease in early-onset dA. Citrate is generally tolerated better than sodium bicarbonate and can be given as the potassium or sodium salt, depending on the severity of hypokalemia. In patients who present later with kidney stones. large fluid intake and sufficient alkali to restore normal acid-basebalance, correct the hypocitraturia and reduce hypercalciuria, thereby inhibiting the formation of new stones Treatment of Type 2 Proximal A It is difficult to restore normal acid-base balance in patients with proximal A despite large amounts of alkali. This is the case because they continue to waste bicarbonate fractional excretion 15 until the serum level falls below a threshold, usually about 15-17 mmolL, at which time bicarbonate is completely reabsorbed distally and the urine is maximally acidified with pH 5.5. When the serum bicarbonate concentration is raised above the threshold with alkali therapy, bicarbonate wasting recurs and causes hypokalemia as potassium is secreted to maintain luminal electroneutrality. Thus, treatment of pA requires 5-15 mmolkg per day of bicarbonate together with supplemental potassium 