Hyperchloremic Acidosis Symptoms

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Anion gap usmle - anion gap metabolic acidosis normal anion gap metabolic acidosis


The kidneys and lungs maintain the balance (proper pH level) of chemicals called acids and bases in the body. Acidosis occurs when acid builds up or when bicarbonate (a base) is lost. Acidosis is classified as either respiratory or metabolic acidosis. Respiratory acidosis develops when there is too much carbon dioxide (an acid) in the body. This type of acidosis is usually caused when the body is unable to remove enough carbon dioxide through breathing. Other names for respiratory acidosis are hypercapnic acidosis and carbon dioxide acidosis. Causes of respiratory acidosis include: Chest deformities, such as kyphosis Chest injuries Chest muscle weakness Chronic lung disease Overuse of sedative drugs Metabolic acidosis develops when too much acid is produced in the body. It can also occur when the kidneys cannot remove enough acid from the body. There are several types of metabolic acidosis: Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when substances called ketone bodies (which are acidic) build up during uncontrolled diabetes. Hyperchloremic acidosis is caused by the loss of too much sodium bicarbonate from the body, which can happen with severe diarrhea. Continue reading >>

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  1. Oh_Moneypenny

    Hi everybody! I'm on my fifth day of eating strictly keto and have been loving it so far, except that my depression has gotten drastically worse in the last two days. I've had clinical depression off and on since I was 20 and have managed to treat it through therapy and basically white knuckling my way through it (every antidepressant I've tried has shifted me into a manic state and also made me gain excess weight (see my flair), so I refuse to treat it pharmaceutically).
    I started keto to lose weight and was hopeful that it would help manage my depression. For the first few days it did: it's been months since I felt that normal. But yesterday and today have been absolutely terrible, worse than I've felt in months.
    I've been tracking everything I eat through MFP, and have managed to hit my protein (or go over by 1-5 g) every day. I've been at or slightly under my carb limit of 20 g and haven't hit my fat limit yet (which I understand is ok, correct?). I've been watching my electrolytes through bullion cubes, nu salt, and avocados. I've managed to avoid the keto flu and never experienced any headaches or cramps, just some slight tiredness.
    Here is my output from the keto calculator: 28/F/5'8" | CW 246 | 48% BF | Mostly sedentary
    1822 kcal Goal, a 20% deficit. (690 min, 2277 max)
    20g Carbohydrates
    85g Protein (78g min, 128g max)
    156g Fat (30g min, 206g max)
    I've got an emergency appointment with my therapist on Monday afternoon, but she (obviously) is not an expert in nutrition so I figured I'd check here before seeing her.
    TL;DR could the increased depression be part of the keto flu?

  2. Gobhoblin47

    Probably withdrawals from sugar

  3. EspressoMuse

    My depression got worse right around day 5 and was down/struggling for a few days, but after I got past that carb withdrawal hump and a bit more adapted within days I felt better then I had in a looooong time. Don't know how typical this is, but just because you're having a down swing isn't necessarily a need for concern yet. Give it time. I'm still feeling quite good an I'm about 8 weeks in now.

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this will be a series of lectures to illustrate in simple and precise way how you can manage acid-base imbalance in practical step by step approach.

Approach To The Adult With Metabolic Acidosis

INTRODUCTION On a typical Western diet, approximately 15,000 mmol of carbon dioxide (which can generate carbonic acid as it combines with water) and 50 to 100 mEq of nonvolatile acid (mostly sulfuric acid derived from the metabolism of sulfur-containing amino acids) are produced each day. Acid-base balance is maintained by pulmonary and renal excretion of carbon dioxide and nonvolatile acid, respectively. Renal excretion of acid involves the combination of hydrogen ions with urinary titratable acids, particularly phosphate (HPO42- + H+ —> H2PO4-), and ammonia to form ammonium (NH3 + H+ —> NH4+) [1]. The latter is the primary adaptive response since ammonia production from the metabolism of glutamine can be appropriately increased in response to an acid load [2]. Acid-base balance is usually assessed in terms of the bicarbonate-carbon dioxide buffer system: Dissolved CO2 + H2O <—> H2CO3 <—> HCO3- + H+ The ratio between these reactants can be expressed by the Henderson-Hasselbalch equation. By convention, the pKa of 6.10 is used when the dominator is the concentration of dissolved CO2, and this is proportional to the pCO2 (the actual concentration of the acid H2CO3 is very lo Continue reading >>

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  1. spblind

    I've googled and there are so many different answers, i don't know which to believe !

  2. rundymc

    When you're breath stinks more than usual.

  3. spblind

    rundymc wrote:
    When you're breath stinks more than usual. i don't feel it leh, i've been on a keto diet for a week, 65% of fats intake and 35% of protein 0% carbs.
    but my urine become damn yellow and the smell of fats oil, very bubbly and thick also and of cos the first few days i felt very giddy and i don't even feel like doing anything, like crashing like that but now better alot alr.

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Treating Intraoperative Hyperchloremic Acidosis With Sodium Bicarbonate Or Tris-hydroxymethyl Aminomethane: A Randomized Prospective Study

We demonstrated that saline infusion of approximately 35 mL/kg within 2 h during anesthesia and surgery will inevitably lead to hyperchloremic acidosis in a dose-dependent manner (1) . Also, the infusion of saline-based colloid solutions will result in hyperchloremic acidosis (2) . In this context, the seemingly harmless and benign character of this acid-base disturbance was called into question (35) . Still, severe hyperchloremic acidosis should be avoided. One possibility to reach this target is the use of balanced solutions, such as lactated Ringers solution or Hextend (1,3,4) . The second possibility is correcting this acidosis at an early state. Until now, however, there was an open discussion as to the better concept for treating this kind of acidosis: with sodium bicarbonate (BIC) or tris-hydroxymethyl aminomethane (THAM) (6) . Undoubtedly, both drugs may lead to a correction of the acidosis; however, the respective effects on mechanical ventilation aiming at constant Paco2 and serum concentrations of electrolytes or unmeasured ions should be very different. By comparing two groups of patients with intraoperative hyperchloremic acidosis caused by 0.9% saline infusion and ra Continue reading >>

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  1. needtolose4me2

    since last week when I messed up and had some ad carbs one day, I basically started over Tuesday. I was really good all day Tuesday and Wednesday. Wednesday night I used a ketosis stick and it came up "trace". is that normal?should it take longer to get into ketosis? I was doing good the first 3 weeks (however not measuring my ketone levels) then all of a sudden I gained 2 pounds at which point I got aggrivated and screwed up for one day. the next day I got right back in the groove. I know my carbs are low, Ihaven't gotten on a scale,but this trace amount of keytones is concerning me. DO you think I should do some kind of fast (could onl really stomach the macadamia nut one) or wait it out a bit longer?

  2. JerseyGyrl

    I would not be too concerned about the Ketosis Stix....they have been known to not be accurate. If you are drinking a lot of water (as you should be) or eating a lot of fat & protein, they can give you false readings.
    Eating something you shouldn't, can definately knock you out of ketosis. Getting back into ketosis can vary depending on the person.
    As far as "fasts" are concerned, personally, I woudn't consider a fast unless I was in a very serious stall (not losing lbs OR inches). My best advice to you is to do a clean induction (only real foods..meat,eggs,cheese, veggies, etc) and be patient. Sometimes we get so anxious to lose the unwanted pounds we forget that we didn't gain them overnite & we aren't going to lose them overnite.
    All the best to you,

  3. Tiffany_Bracelet

    For me, it depends on the amount of water and foods that I consume. Ketosis makes my mouth really dry....so I don't go into a deep ketosis like I have before with the meat/egg fast.

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