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Metabolic Acidosis Definition

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Treatment Of Acute Non-anion Gap Metabolic Acidosis

Go to: Introduction Acute metabolic acidosis (defined temporally as lasting minutes to a few days) has traditionally been divided into two major categories based on the level of the serum anion gap: non-anion gap and high anion gap metabolic acidosis [1]. As implied, with the former acid–base disorder, the anion gap is within normal limits, whereas with the latter disorder it is increased. This categorization is primarily used to facilitate the differential diagnosis of metabolic acidosis. However, it also has relevance for predicting the clinical outcome and determining indications for treatment. Although many clinicians presume that acute metabolic acidosis in seriously ill patients will be due to a high anion gap acidosis, recent studies indicate that a non-anion gap metabolic acidosis or combination of non-anion gap and high anion gap metabolic acidosis might be more frequent [2, 3]. Based on these observations, it appears important to more clearly define the potential effects of non-anion gap metabolic acidoses on organ function as a basis for generating evidence-based guidelines for therapy. In the present review, we summarize our current understanding of the pathophysiolog Continue reading >>

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Popular Questions

  1. AngelaR

    Later in January it will be time for my annual physical. The doc wants to do bloodwork and cholesterol testing. He is not supportive of LC...he is a low fat fanatic with me because of the severe gall bladder attacks I was having 4 years ago. I have not mentioned to him that I was LCing, but the last time I saw him I mentioned that I was "eating healthier" His response was "ahh, low fat, you finally got the message"
    If I am in ketosis when the bloodwork is done (or the urine sample), will it show up in the tests? I know this is a broad question because there are a lot fo different tests that are done on blood and urine. He will be checking mostly for cholesterol, and probably redoing the test for hormones because I am pre-menopausal.
    I don't want to have to justify how I am eating to the man who was only interested in prescribing drugs to fix all the post gall bladder surgery problems I had (which by the way have disappeared since I started LCing)
    I bought a bottle of Ketostix just for kicks a while back, rarely use them, and have never registered more than trace ketosis.

  2. Natrushka

    Yes, Angela. It will show up in the urine sample. I had mine tested back in September and when I got the results back I saw the 1.5 reading for Ketones in the urine (small / trace).
    This might be a good time to let him know what you're doing. You've lost weight, you're feeling good, he's pleased with your progress so far? If all your blood work is glowing then maybe it's time to let him know just how wrong he's been?
    Alternatively, because you're fasting you can't eat 12 hours before the test, but you can drink water. You should be able to dilute the concentration a bit, but I think there will still be a trace element left. Exercising the day before and drinking a few litres of water would help lessen the amount though.
    N

  3. doreen T

    No doubt, you will be in a fasting state -- 8 to 12 hrs is required for fasting blood sugar, cholesterol and triglycerides. You would be wise to drink lots of water during this fasting time, especially on rising the morninig of the tests. No coffee or caffeine for 18 hrs prior -- they don't tell you this, but it can alter the triglyceride readings.
    Any ketones present in the urine will be detected during the routine urinalysis. But unless your urine is concentrated, or you've eaten a fatty meal a few hours prior to the test, I seriously doubt that there will be more than a trace present. As a nurse, I can tell you this is considered normal, especially if the dr. considers that you have been fasting Note - routine urinalysis is done by the nurse right there in the office, using a dipstick just like the ketone strips ... but having 5 or more reactive pads on it, to test for different things -- pH (should be slightly acidic), specific gravity (how concentrated it is) , glucose, ketones and protein. Eating protein won't lead to protein in the urine unless your kidneys are diseased or your liver is unable to break down the amino acids. Protein in the urine usually indicates infection, or kidney disease.
    Blood tests are expensive, so unless the doc. specifically orders for serum ketone levels to be checked, then it's not going to be looked for .. Just as for the urine test ... it's considered normal for there to be some ketones present while in a fasting state -- for all persons, not just low-carbers.
    My 2¢ - Getting back the blood reports and having them be improved from previous (or perfectly normal if never checked before) would be a good time to tell your dr. that you are following a carb-controlled program. Especially since you've successfully lost weight as well. That's why I did ... my doc was skeptical at first, but impressed with improved bloodwork, lowered blood pressure and lbs lost ... plus I showed her some sample menus of what I was eating. When she saw the salads, vegetables and lean meats, olive oil .. and no chips, cookies or white bread ... she softened her view, and has been very supportive ever since.
    Doctors are just a susceptible as anybody to the public mythology and media, which depicts Atkins and low carb as eating huge fatty steaks and cheese, with great gobs of lard and bacon by the slab ... and nothing else.
    Good luck to you!
    Doreen

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