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Metabolic Acidosis Pathophysiology

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Pathogenesis, Consequences, And Treatment Of Metabolic Acidosis In Chronic Kidney Disease

The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2018 UpToDate, Inc. All topics are updated as new evidence becomes available and our peer review process is complete. INTRODUCTION — Most individuals produce approximately 15,000 mmol (considerably more with exercise) of carbon dioxide and 50 to 100 meq of nonvolatile acid each day. Acid-base balance is maintained by normal elimination of carbon dioxide by the lungs (which affects the partial pressure of carbon dioxide [PCO2]) and normal excretion of nonvolatile acid by the kidneys (which affects the plasma bicarbonate concentration). The hydrogen ion concentration of the blood is determined by the ratio of the PCO2 and plasma bicarbonate concentration. (See "Simple and mixed acid-base disorders", section on 'Introduction'.) Acidosis associated with chronic kidney disease (CKD) will be discussed in this topic. An overview of simple acid-base disorders an Continue reading >>

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Popular Questions

  1. Dan360

    The good, the bad and the ugly of metformin

    I have been taking metformin sense the day I was first diagnosed with type 2 diabetes. As you probably know, it is the first-line drug of choice for the treatment of type 2 diabetes and I doubt that there are many of you that do not take metformin. Metformin works by suppressing glucose production by the liver. Evidence suggests metformin may prevent the cardiovascular and possibly the cancer complications of diabetes. It helps reduce LDL cholesterol and triglyceride levels and is not associated with weight gain; in some people, it promotes weight loss. Metformin is one of only two oral antidiabetics in the World Health Organization Model List of Essential Medicines.
    One of my first experiences with diabetes was finding that when I worked out my glucose level would actually increase. That was very frustrating sense I was working out to lower levels of glucose. When I told my doctor she put me on a heavier dose of metformin, 1000 mg twice a day. As with most drugs the treatment of one problem often causes another. There is a whole list of side effects associated with metformin: abdominal or stomach discomfort, cough or hoarseness, decreased appetite, diarrhea, fast or shallow breathing, fever or chills, general feeling of discomfort, lower back or side pain, muscle pain or cramping and painful or difficult urination. Other problems metformin may cause which will usually diminish over time is: Acid or sour stomach, belching, bloated, excess air or gas in the stomach or intestines, full feeling, heartburn, indigestion, loss of appetite, metallic taste in the mouth, passing of gas, stomachache, stomach upset or pain and vomiting. I hope this isn’t too much information!
    My latest experience with metformin was excess air or gas in the stomach. I experienced what seem to be a swelling in my throat followed by belching or burping. I cut my dose of metformin in half and the problem went away. Have any of you experienced discomforts with metformin?

  2. govna

    Let me tell you about my awful 3 year journey with metformin! I dealt with all the horrible side affects for a few years Mostly massive pain and intestinal bloating all that goes with it to the point of doctors taking out my gall bladder then on to a colonoscopy and endoscopy and then on to a stress test! All was "just fine" Finally doc said take me off the metformin since a small percentage of people cannot tolerate metformin. Well low and behold I was one of them! After about two weeks most all of the hellish discomfort disappeared! I now take 50 units of toujeo every morning feel great and found a new lease on life energy wise! I am back baby!!!! It is just a shame looking back on how long I suffered needlessly. Not to mention the metformin wasn't even bringing my sugar down anyhow. All it did was make me extremely sick!!!

  3. Scared ****less

    join the club Metformin was a nightmare too the stomach pain was terrible but lucky my dr took me them a week later

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