Snapshot A 10-year-old girl with a past medical history of epilepsy presents to the emergency room after sustaining a fall on the playground. She was fatigued and confused after the event and complained of pain in her wrist. On review of systems, she endorsed polyuria and polydipsia. Relevant medications included valproic acid, started 6 months ago, for her epilepsy. On physical exam, her right wrist was erythematous, swollen, and tender. Laboratory evaluation revealed hypokalemia, hypocalcemia, hypophosphatemia, and a mild metabolic acidosis. Introduction Clinical definition login to view 1 more bullet Epidemiology login to view 4 more bullets Etiology login to view 14 more bullets Pathogenesis login to view 7 more bullets Associated conditions login to view 4 more bullets Prognosis login to view 4 more bullets Presentation Symptoms login to view 14 more bullets Physical exam login to view 4 more bullets Studies Labs login to view 7 more bullets Urine studies login to view 6 more bullets Diagnostic criteria login to view 3 more bullets Differential Distal renal tubular acidosis (type 1) login to view 1 more bullet Hyperkalemic renal tubular acidosis (type 4) login to view 1 more bullet Treatment Conservative login to view 4 more bullets Medical login to view 6 more bullets Complications Bone disease (osteomalacia, osteopenia, and osteoporosis) Renal insufficiency