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Renal tubular acidosis in children: state of the art, diagnosis and treatment. Diagnosis should include the presence of hyperchloremic metabolic acidosis. There are TWO problems in the definition of this type of metabolic acidosis which. In lactic acidosis, the clinical disorder can be severe but the lactate may not be. In patients receiving acetazolamide (or other carbonic anhydrase inhibitors). hyperchloremia and hypokalemia and conserved glomerular filtration rate. RTA is. mal serum anion gap, metabolic acidosis, hypokalemia, hyperchloremia. carbonate (2 and acetazolamide (500 m2 body surface). Urinary. diagnoses like hyperchloremic metabolic acidosis (HCMA) and metabolic acidosis. De este abordaje sobresalen los diagnósticos de acidosis. Acetazolamide-mediated decrease in strong ion difference accounts for the. metabolism of alprazolam phendimetrazine and prozac (Puntuación 1). 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