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Metabolic Acidosis Pathophysiology Ppt

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New Findings On The Pathogenesis Of Distal Renal Tubular Acidosis

The Kidney in Genetic and Rare Diseases: Review New Findings on the Pathogenesis of Distal Renal Tubular Acidosis Trepiccione F.a Prosperi F.a, b de la Motte L.R.a, b Hbner C.A.c Chambrey R.d Eladari D.e Capasso G.a, b aDepartment of Cardiothoracic and Respiratory Science, University of Campania Luigi Vanvitelli, Naples, and bBiogem S.c.a.r.l., Research Institute Gaetano Salvatore, Ariano Irpino, Italy; cInstitute of Human Genetics, Jena University Hospital, Friedrich Schiller University, Jena, Germany; dInserm U1188, Diabte athrothrombose Thrapies Runion Ocan Indien (DTROI), Universit de La Runion, and eService d'Explorations Fonctionnelles Rnales, Hpital Felix Guyon, CHU de la Runion, Saint-Denis, Ile de la Runion, France Department of Cardiothoracic and Respiratory Science University of Campania Luigi Vanvitelli E-Mail [email protected] Background: Distal renal tubular acidosis (dRTA) is characterized by an impairment of the urinary acidification process in the distal nephron. Complete or incomplete metabolic acidosis coupled with inappropriately alkaline urine are the hallmarks of this condition. Genetic forms of dRTA are caused by loss of function mutations Continue reading >>

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Popular Questions

  1. kryptomancer

    Experienced fasters: How long does it take you to reach ketosis?

    It seems that it takes about 3 days for the average person to get into a state of ketosis when fasting.
    For those of you who are veterans of fasting, especially longer fasts (5+ days), how long does it take you to get into ketosis?
    I'm curious about this due to this guy going into ketosis in only 2 days on his second 5 day fast. Was wondering if it was due to the avocado or his body just adapting faster.

  2. Glarsie

    You should be in ketosis once your liver glycogen stores are depleted. In a fast this should occur in 24-48hrs after your last meal and will be influenced by your insulin sensitivity (which affects you basal insulin level) and the amount of glycogen in your liver (ie what you ate leading up to the fast). It's entirely possible (some would argue desirable) to be in ketosis before fasting. Nutritional ketosis generally starts when you have a betahydroxybuterate level greater than .5 mmol/L which can't be accurately measured through urine ketostix which only show excreted acetoacetate (not blood concentrations of BHB). You can turn those keto sticks dark purple just by restricting fluid intake and becoming slightly dehydrated or equally make them not register by drinking half a gallon of water.
    Ketosis is brought on by a lack of carbohydrates/insulin and not by the presence of fat.
    Eat under 20g of net carbs per day (don't count fibre) for 3 days and you will be in ketosis. You will probably be in ketosis sooner, but 3 days is pretty true for everyone.
    Remember that as you produce ketones you will start to use them as well as free fatty acids for fuel (less is excreted in urine and blood levels don't increase indefinitely). In the end ketones will be used primarily for your brain and other tissues not able to use FFA while glucose will be reserved for cells that can only use glucose (eg red blood cells and some parts of the brain). The breakdown of triglycerides into FFAs also releases glycerol that is converted into glucose to supply the now reduced demand for glucose. This doesn't happen as soon as you produce ketones but over a few days as your levels increase.
    Edit: nutritional ketosis defined as starting at .5 rather than .3 mmol/l

  3. kryptomancer

    this should occur in 24-48hrs after your last meal
    Actually in the link I posted it took 3 days initially for the guy to go into ketosis, then on the second time through it only took him 2. I'm very interested in to why this was as I am planning on doing a series of longer fasts and want to make it as easy as possible.
    and will be influenced by your insulin sensitivity
    So perhaps the reason why the 2nd fast was quicker to get into ketosis with due to increased insulin sensitivity from his initial fast?
    and the amount of glycogen in your liver (ie what you ate leading up to the fast).
    This is my current plan: eat under 20g carbs for two days, start water fasting on the third and lifting heavy squats and dead lifts; then taking apple cider vinegar before bed.

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What is ALKALOSIS? What does ALKALOSIS mean? ALKALOSIS meaning - ALKALOSIS pronunciation - ALKALOSIS definition - ALKALOSIS explanation - How to pronounce ALKALOSIS? Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Alkalosis is the result of a process reducing hydrogen ion concentration of arterial blood plasma (alkalemia). In contrast to acidemia (serum pH 7.35 or lower), alkalemia occurs when the serum pH is higher than normal (7.45 or higher). Alkalosis is usually divided into the categories of respiratory alkalosis and metabolic alkalosis or a combined respiratory/metabolic alkalosis. Respiratory alkalosis is caused by hyperventilation, resulting in a loss of carbon dioxide. Compensatory mechanisms for this would include increased dissociation of the carbonic acid buffering intermediate into hydrogen ions, and the related excretion of bicarbonate, both of which lower blood pH. Hyperventilation-induced alkalosis can be seen in several deadly central nervous system diseases such as strokes or Rett syndrome. Metabolic alkalosis can be caused by repeated vomiting, resulting in a loss of hydrochloric acid within the stomach content. Severe dehydration, and the consumption of alkali are other causes. It can also be caused by administration of diuretics and endocrine disorders such as Cushing's syndrome. Compensatory mechanism for metabolic alkalosis involve slowed breathing by the lungs to increase serum carbon dioxide, a condition leaning toward respiratory acidosis. As respiratory acidosis often accompanies the compensation for metabolic alkalosis, and vice versa, a delicate balance is created between these two conditions. Metabolic alkalosis is usually accompanied by low blood potassium concentration, causing, e.g., muscular weakness, muscle pain, and muscle cramps (from disturbed function of the skeletal muscles), and muscle spasms (from disturbed function of smooth muscles). It may also cause low blood calcium concentration. As the blood pH increases, blood transport proteins, such as albumin, become more ionized into anions. This causes the free calcium present in blood to bind more strongly with albumin. If severe, it may cause tetany.

Chapter 47. Acidosis And Alkalosis

DuBose TD, Jr.. DuBose T.D., Jr. DuBose, Thomas D., Jr.Chapter 47. Acidosis and Alkalosis. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. Longo D.L., Fauci A.S., Kasper D.L., Hauser S.L., Jameson J, Loscalzo J Eds. Dan L. Longo, et al.eds. Harrison's Principles of Internal Medicine, 18e New York, NY: McGraw-Hill; 2012. Accessed April 24, 2018. DuBose TD, Jr.. DuBose T.D., Jr. DuBose, Thomas D., Jr.. "Chapter 47. Acidosis and Alkalosis." Harrison's Principles of Internal Medicine, 18e Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. Longo D.L., Fauci A.S., Kasper D.L., Hauser S.L., Jameson J, Loscalzo J Eds. Dan L. Longo, et al. New York, NY: McGraw-Hill, 2012, Systemic arterial pH is maintained between 7.35 and 7.45 by extracellular and intracellular chemical buffering together with respiratory and renal regulatory mechanisms. The control of arterial CO2 tension (Paco2) by the central nervous system (CNS) and respiratory systems and the control of the plasma bicarbonate by the kidneys stabilize the arterial pH by excretion or retention of acid or alkali. The metabolic and respiratory components that regulate systemic pH are described by the He Continue reading >>

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Popular Questions

  1. JamesShaw

    Hi. I'm 3 weeks in, and my wife is just a little behind - she wasn't being strict when she started but now she's getting on board. She's not here, but she did ask if there were any differences for women.
    Is it harder for women to get into ketosis or fat-adapted?
    We have a ketonix; mine is current 8, hers 5. I'm assuming we're not quite there yet. But would numbers mean the same for a woman?
    Are carb grams guidelines the same for women? I'm keeping as low as possible - <20g. But I'm 240, she's 170.. does she need to keep lower and be stricter?

    Thank you Ladies for any tips/tricks I can pass on.

  2. Bahrutile

    My lady and I have been keto for about 5 months, I'm continually losing wieght with little effort. She is not and she is much more strict on her macros than I am. She hit a rough patch between week 3 and 8, her depression hit hard. We've got through that, though she's not losing wieght the way she wants, she still keeps close watch on her macros with my fitness pal... so yes keto can be harder on the ladies.

  3. Euphillia

    Yes. Women have a lot of hormonal healing before we start seeing those big weight loss rusults initially. She is absolutely not alone in this. Assure sure it's working in other ways and she will see it soon. If anything she will start feeling better before seeing it.

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Dan Dhuyvetter of Ridley Block Operations explains how supplemental blocks can help prevent subacute rumen acidosis in livestock.

Subacute Ruminal Acidosis

(Chronic ruminal acidosis, Subclinical ruminal acidosis) By Ingrid Lorenz, DMV, DMVH, DECBHM, Lecturer in Bovine Medicine, School of Agriculture, Food Science and Veterinary Medicine, University College Dublin Ruminant animals are adapted to digest and metabolize predominantly forage diets; however, growth rates and milk production are increased substantially when ruminants consume high-grain diets. One consequence of feeding excessive amounts of rapidly fermentable carbohydrates in conjunction with inadequate fiber to ruminants is subacute ruminal acidosis, which is characterized by periods of low ruminal pH that resolve without treatment and is rarely diagnosed. Dairy cows, feedlot cattle, and feedlot sheep are at risk of developing this condition. Ruminal pH fluctuates considerably during a 24hr period (typically between 0.51 pH units) and is determined by the dynamic balance between the intake of fermentable carbohydrates, buffering capacity of the rumen, and rate of acid absorption from the rumen. In general, subacute ruminal acidosis is caused by ingestion of diets high in rapidly fermentable carbohydrates and/or deficient in physically active fiber. Subacute ruminal acidosi Continue reading >>

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Popular Questions

  1. Emacfarland

    I'm confused about what defines being in nutritional ketosis based on blood levels. The Diet Doctor website says 1.5 is considered ketosis while I've heard on Keto Talk from Doc Nally that fit and active people can be in ketosis at levels of .3 or .4 and that higher levels don't necessarily mean better. So I'm not sure what the heck I'm aiming for! If I get readings below 1.5 am I doing something wrong? I am fit and active and Doc Nally has said this can make blood ketone level readings lower because an active persons body is using the ketones more efficiently. Should I be aiming for higher levels?

  2. BillJay

    It seems that the longer someone is keto-adapted, the more their body produces just the right amount of ketones and what we measure in the blood is only what's not actually being used, therefore it seems not only possible, but likely that people are in ketosis even with lower betahydroxybutyrate (BHB) levels - the ketone in the blood that these meters measure.
    This is somewhat frustrating for me since I'd like for there to be an objective measurement of being in ketosis, but that seems to be elusive.
    Therefore, a better indication is your level of carbs since it is HIGHLY unlikely that anything over 50 carbs is in ketosis and more likely that keeping carbs under 20 grams is a safe bet. Another indication is keeping protein at moderate levels which is 1.0 to 1.5 grams per kilogram of lean body weight.
    Once the macro-nutrients are in the proper range, I think that signs of keto-adapation are more poignant and below is a post from Mark Sisson on Dr. Mercola's site that explains many of the signs of being keto-adapted.

    What Does It Mean to Be Fat Adapted?
    543

  3. richard

    Dr Phinney invented the term so he gets to define it.
    In his book "The art and science of low carbohydrate living" he gives the range from 0.5 to 3.0 mmol/l
    But recently he mentioned that some of Dr Volek's very athletic subjects were clearly in ketosis at 0.2 mmol/l.
    My personal range is from 0.2 to 0.8 mmol/l, and I have been in ketosis for almost 3 years. Prof Tim Noakes is also normally in the same range 0.2-0.8.
    I suspect when we first start we aren't good at using them so we make too many and use too little so we end up with a lot left in our blood. After we become better adapted we end up in whatever physiological range our bodys feel best ensures our survival. And people who are trained and good fat burners may be able to get away with less because they can make it easily.
    When I fast for 3 days and then do 3 hours of exercise my ketones can go as high as 3.5. But I know people who regularly get up to 7.
    It's worth pointing out that Dr Nally has mentioned in his most recent podcast that he eats exogenous ketones 3 times a day. And he sells them.

    Personally I wouldn't be worried. I think you are doing fine.

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