George K, Upadhyay AD, Subbiah AK, et al. - Metabolic acidosis (MA) incidence was high in the initial 6 months post-renal transplantation, and independent risk factors were serum creatinine and high tacrolimus C0 levels.

• Single center study was conducted with 125 patients of whom 89 (71.2%) developed MA.

• Post-transplantation, MA occurred in 72 patients in the first month, in 11 patients during the 2–3 months and in 6 patients between 4 and 6 months.

• Among 89 patients, type 1 renal tubular acidosis (T1RTA) occurred in 55(61.8%) and type 2 RTA and type 4 RTA in 27 (30.3%) and 7 (7.9%), respectively.

• There was a high anion gap MA after severe graft rejection in two patients who had T1RTA.