Can Starvation Cause Metabolic Acidosis?

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A Rare Cause Of Severe Metabolic Acidosis: Presurgical Fasting - Sciencedirect

Volume 42, Issue 4 , OctoberDecember 2014, Pages 312-316 A rare cause of severe metabolic acidosis: Presurgical fastingUna causa inusual de acidosis metabolica severa: ayuno prequirrgico Author links open overlay panel Carlos EduardoLaverde-Sabogala To discuss a clinical case and a non-systematic literature review on severe metabolic acidosis due to pre-surgical fasting, its incidence, etiology, and pathophysiology. Discussion of a case of a patient with fasting-induced severe metabolic acidosis during a laparoscopic cholecystectomy, its management and outcomes. The Ethics Committee of our institution approved the case discussion. The literature search included Pub Med, Scielo and Bireme. Fasting-induced metabolic acidosis is underdiagnosed and is related to the search for an alternate energy source in the absence of glucose and glycogen. Free fatty acids are these alternate source and generate ketone bodies that accumulate and lead to the development of acidosis. This is the first case of a non-diabetic patient at our institution. We found no other reports at the national level. There are some cases in the world literature associated with fasting from vomiting during the third tr Continue reading >>

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  1. metalmd06

    Does acute DKA cause hyperkalemia, or is the potassium normal or low due to osmotic diuresis? I get the acute affect of metabolic acidosis on potassium (K+ shifts from intracellular to extracellular compartments). According to MedEssentials, the initial response (<24 hours) is increased serum potassium. The chronic effect occuring within 24 hours is a compensatory increase in Aldosterone that normalizes or ultimatley decreases the serum K+. Then it says on another page that because of osmotic diuresis, there is K+ wasting with DKA. On top of that, I had a question about a diabetic patient in DKA with signs of hyperkalemia. Needless to say, I'm a bit confused. Any help is appreciated.

  2. FutureDoc4

    I remember this being a tricky point:
    1) DKA leads to a decreased TOTAL body K+ (due to diuresis) (increase urine flow, increase K+ loss)
    2) Like you said, during DKA, acidosis causes an exchange of H+/K+ leading to hyperkalemia.
    So, TOTAL body K+ is low, but the patient presents with hyperkalemia. Why is this important? Give, insulin, pushes the K+ back into the cells and can quickly precipitate hypokalemia and (which we all know is bad). Hope that is helpful.

  3. Cooolguy

    DKA-->Anion gap M. Acidosis-->K+ shift to extracellular component--> hyperkalemia-->symptoms and signs
    DKA--> increased osmoles-->Osmotic diuresis-->loss of K+ in urine-->decreased total body K+ (because more has been seeped from the cells)
    --dont confuse total body K+ with EC K+
    Note: osmotic diuresis also causes polyuria, ketonuria, glycosuria, and loss of Na+ in urine--> Hyponatremia
    DKA tx: Insulin (helps put K+ back into cells), and K+ (to replenish the low total potassium
    Hope it helps

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Acute Starvation In Pregnancy: A Cause Of Severe Metabolic Acidosis - Sciencedirect

Volume 20, Issue 3 , July 2011, Pages 253-256 Acute starvation in pregnancy: a cause of severe metabolic acidosis Author links open overlay panel A.Patelab Get rights and content We report a case of starvation-induced metabolic ketoacidosis in a previously healthy 29-year-old, nulliparous woman at 32weeks of gestation. She was admitted to hospital with mild preeclampsia associated with persistent nausea and vomiting that progressed to severe preeclampsia requiring urgent control of hypertension before caesarean delivery. Prolonged and severe vomiting limited oral caloric intake and led to starvation ketoacidosis, characterised by ketonuria and a raised anion gap metabolic acidosis that required intensive care support. Despite significant metabolic derangement the patient appeared clinically well. Intravascular volume was replenished. Fluid restriction used as part of our preeclampsia treatment regimen delayed the therapeutic administration of sufficient dextrose, which rapidly corrected her metabolic derangement when commenced after delivery. Electrolyte supplementation was given to prevent re-feeding syndrome. Both mother and baby were discharged without sequelae. Continue reading >>

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  1. Ramra

    I've managed to stay in Ketosis for a week now, and I even dropped a few pounds. But last night I went to my mom's, and ate quite a bit. It was all induction-friendly foods, such as turkey and salads. I weighed myself this morning and I'm up 6 lbs! I'm hoping this is just water weight, but I don't understand how this could happen as I only do light excerise and I'm nowhere near my TOM. It couldn't have been that much food!
    Is it possible to gain weight during ketosis?

  2. Sunshine73

    It is possible to gain weight in ketosis - calories still matter. However, I think I can confidently say that you did NOT eat enough last night to gain 6.5 pounds. Most likely it's water weight - which can be caused by a million different things - for me one of the biggest culprits is sodium. Just hang in there and ride out this fluctuation.

  3. Mikani

    It sounds to me as if something you ate had too many carbs, possibly hidden sugar, or you simply ate too many carbs from legal food. When you do this, your body will flood your tissues with glucose and water, and you magically gain a Ton of weight overnight. Don't fret too much, just drink your 64 ounces of pure water + an extra few glasses every day until the weight comes off, and you body will let go of that water over the next few days. You might see most of it suddenly come off in a "whoosh", or it may take two-four days, but it will come off. Just get in your water.

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Severe Acidosis Caused By Starvation And Stress.

Severe acidosis caused by starvation and stress. Department of Pediatrics, Children's Hospital of Wisconsin, Milwauke, WI, USA. A 1-year-old boy had severe anoxic brain injury owing to a cardiorespiratory arrest. He had an initial metabolic acidosis, but this largely resolved by hospital day 2. He then had a persistent, profound metabolic acidosis. Evaluation on hospital day 6 found that the patient had ketonemia, ketonuria, and a normal serum glucose level; he had received no intravenous dextrose during his hospitalization. The dextrose-free fluids were given initially to protect his brain from the deleterious effects of hyperglycemia after brain injury. Continuation beyond 24 hours was inadvertent. The initiation of dextrose-containing intravenous fluids produced a rapid resolution of his metabolic acidosis. Starvation usually produces a mild metabolic acidosis, but when combined with physiologic stress, starvation may cause a severe metabolic acidosis. Among the few reports of severe starvation ketoacidosis, our case is unique because the patient was monitored closely in an intensive care unit, allowing us to describe the time course of the acidosis in detail. Continue reading >>

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Popular Questions

  1. Jcorb

    I know that diet-soda is technically keto-friendly, but I'd like to try a healthier alternative, if there is one. Although, I despise tea.
    Any ideas?

  2. change_for_a_nickel

    Source: Kids sitting around a table at starbucks with their eyes popping out of their heads and literally vibrating from excess energy.

  3. Naonin

    Coffee has often been observed as energy inducing and stimulating of the CNS, by a drug labeled "caffeine". In this study, we aim to separate all the chemical components of coffee and feed them one by one to human subjects and observe the effects. Double blind, crossover, 5 week wash out period.
    All funds were provided by the FDA, 11.8 million dollars.

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    Volume 42, Issue 4 , OctoberDecember 2014, Pages 312-316 A rare cause of severe metabolic acidosis: Presurgical fastingUna causa inusual de acidosis metabolica severa: ayuno prequirrgico Author links open overlay panel Carlos EduardoLaverde-Sabogala To discuss a clinical case and a non-systematic literature review on severe metabolic acidosis due to pre-surgical fasting, its incidence, etiology, and pathophysiology. Discussion of a case of a pat ...

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