dRTA can affect children in different ways. Some children do not have any symptoms.

For those who do have symptoms, these might include:

• Feeling very tired or weak
• Slow growth (also known as failure to thrive)
• Excess thirst
• Excess urination
• Feeling or being sick
• Loss of appetite
• Painful bones
• Hearing problems

It is important to seek urgent medical advice if you notice any of these symptoms in a baby or young child.

Children with dRTA can become dehydrated, especially when they are unwell, being sick, have diarrhoea, or in hot weather. Babies and very young children are most at risk because they cannot ask for a drink.

dRTA can cause the body to lose too much salt and other electrolytes in the urine. This can cause constipation, muscle cramps and a craving for salty foods.

The build-up of acid in the blood can affect how bones grow and harden, which can cause rickets (soft, weak bones). Losing too much calcium in the urine can also lead to calcium deposits in the kidneys (nephrocalcinosis) and to kidney stones.

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