Metabolic Acidosis Review

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A Review Article: Sevelamer Hydrochloride And Metabolic Acidosis In Dialysis Patients

A Review Article: Sevelamer Hydrochloride and Metabolic Acidosis in Dialysis Patients Author(s): Yoshinari Oka , Masashi Miyazaki , Shigeko Takatsu , Toshiaki Oohara , Keisuke Toda , Futoshi Uno , Hiroaki Matsuda . Department of Surgery, Saiwai- cho Memorial Hospital, 3-57 Oomotoekimae, Okayama, Japan 700- 0903. Journal Name: Cardiovascular & Hematological Disorders-Drug Targets Sevelamer hydrochloride is a phosphate binder and its effectiveness to reduce the cardiovascular mortality of dialysis patients has been tested. Sevelamer hydrochloride also contains chlorine, so a decrease in bicarbonate due to chlorine load was anticipated and metabolic acidosis thought to associate with sevelamer hydrochloride has been reported in some papers. We reported that sevelamer hydrochloride exacerbated metabolic acidosis in hemodialysis patients, depending on the dosage. Also a Japanese nationwide survey suggested that sevelamer hydrochloride usage potentially aggravates acidosis in dialysis patients. A multi-institute research study by Edmung et al. has shown that metabolic acidosis, with serum CO2 below 17.5 mmol/L, is by itself associated with increased risk of death in dialysis patients. F Continue reading >>

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  1. Daves_Not_Here

    Has anyone else on keto experienced shorter colds? For the first time in at least 30 years, I got over a cold in 24 hours.
    As I've aged, my ability to shake a cold has diminished. When I was younger, I could get a cold, experience the symptoms, tough it out, and in 5 to 7 days, I'd be fully recovered. More recently, my colds have lingered for weeks. In the last 5 years, I've not gotten over a cold without a visit to the doctor after 2 weeks and a course of antibiotics and steroids.
    So, imagine my pleasant surprise when, after starting to experience cold/flu symptoms, I shook them in 24 hours. A bug has been going around our office that has knocked our staff out for up to a week. Everybody's been coughing and the women sound like dudes. The other night, I felt a sore throat coming on as I fell asleep. I woke up throughout the night as it got worse. The next day, I was sore and had no energy. I still went on my 15 minute bike ride but it took 22 minutes. I was at 50% energy for the day, but was curious why my symptoms were not worsening. Went to bed feeling slightly better. Woke up at 5:00 AM - no pain! Couldn't believe it. Carefully swallowed to confirm. Wow. Went on my ride - 16 minutes. Throughout my day, I was at 90%+ energy. I literally had back to back meetings scheduled from 8:00 AM to 8:00 PM which I had considered rescheduling the day before, but kept them all and felt fine. As I type this this morning, I'm at 100% after a 15 minute ride, completely recovered!
    This correlates with my recent adoption of a ketogenic diet. (yes yes, I know, correlation is not causation, it's all water weight loss, I'll die an early death and join Robert Atkins in hell, I can't draw any conclusions from a single anecdote, I got it). One thing that may have directly helped is the suppression of mucus production. Normally, when I get a sore throat, a post-nasal drip kicks in and seems to exacerbate more flu symptoms. This time, there was no congestion or sniffles at all. Has anyone else had a similar experience?
    Dave’s TrendWeight

  2. MagsOnTheBeach

    I read a couple articles about exercise and colds - people who consider themselves healthy and those who exercise regularly have fewer colds and if they do get them, they are sick for half the time as others. Also in a study with mice, certain viruses never caused lung issues when the mice were exercised regularly before exposure.
    They think it is because those who exercise cause tissue inflammation on a regular basis so the body is geared up to heal/repair - when you don't exercise, the body struggles to make those repairs.
    I'm not doing keto but I was reflecting last night on how at least once a month I had a cold or migraine before I started to lose weight and exercise. Since January, the most I have felt was worn out, after a good night of sleeping, I feel better.

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

Metabolic Acidosis: Pathophysiology, Diagnosis And Management

Abstract | Metabolic acidosis is characterized by a primary reduction in serum bicarbonate (HCO3 concentration, a secondary decrease in the arterial partial pressure of carbon dioxide (PaCO2) of ~1 mmHg for concentration, and a reduction in blood pH. Acute forms (lasting minutes to several days) and chronic forms (lasting weeks to years) of the disorder can occur, for which the underlying cause/s and resulting adverse effects may differ. Acute forms of metabolic acidosis most frequently result from the overproduction of organic acids such as ketoacids or lactic acid; by contrast, chronic metabolic acidosis often reflects bicarbonate wasting and/or impaired renal acidification. The calculation of the serum ] + [Cl]), aids diagnosis by classifying the disorders into categories of normal (hyperchloremic) anion gap or elevated anion gap. These categories can overlap, however. Adverse effects of acute metabolic acidosis primarily include decreased cardiac output, arterial dilatation with hypotension, altered oxygen delivery, decreased ATP production, predisposition to arrhythmias, and impairment of the immune response. The main adverse effects of chronic metabolic acidosis are increase Continue reading >>

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  1. tigherblood

    So I've been trying to specify my macros more and I'm a little stuck on how much protein I should be eating. My weight is 184 and I would estimate myself to be about 45% body fat percentage and I'm going to put down sedentary to be conservative, but I'm getting a few different answers from different sources. I looked into a couple of formulas as well as a few keto calculators. I'm basically getting anywhere from 60g of protein a day (I find this really hard to believe because I just can't seem to figure out a way to eat 1300 cal, under 20g carbs, and under 60g protein.)
    At the same time, I'm nervous that eating up to 90g of protein will be too much! In addition on formula I did said that it should be .6 of your weight?? That's over 100g of protein for me!
    Can anyone shed light to this?

  2. anbeav

    Use the keto calculator in the side bar and set it based on activity and lean body mass
    Sedentary: 0.8 grams per lb LBM
    Moderate endurance/strength training: 0.8 to 1 gram per lb LBM
    What are your stats? Details would be helpful to know if 100 grams is too much
    It's best to follow your protein goal, but you have to massively overeat protein to affect ketosis so don't worry too much about this once it's set.

  3. tigherblood

    Keto Calculator for macros
    That's the first calculator I used and it gives me a range of 61-101g of protein. Now because I've chosen sedentary, it tells me I should go with 61g, but I found that really hard to stick with, so I looked at some other sources to help. My height is 5'4", by the way. Again, I'm just concerned that if I go up to 80 or 90g, which is more realistic (seriously 60g is like 4 pieces of chicken and a stalk of broccoli) that it'll be too much because I'm not being very active at the moment
    Thanks for your response, by the way!

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A Comprehensive Review Of Metabolic Acidosis

A comprehensive review of metabolic acidosis Summarized from Kraut J, Madias N. Metabolic acidosis: pathophysiology diagnosis and management. Nat Rev Nephrol 2010; 6: 274-85 Arterial blood gas analysis is used to assess and monitor patient acid-base status. Disturbance of acid-base balance is classified to one of four main types depending on the pH, pCO2(a) and bicarbonate results generated during blood gas analysis; the four types are respiratory acidosis, respiratory alkalosis, metabolic acidosis and metabolic alkalosis. A recent review article focuses on one of these disturbances, metabolic acidosis, which is characterized by primary decrease in bicarbonate and compensatory decrease in pCO2(a). pH may be either reduced (if compensation is incomplete) or normal (if compensation is complete). This wide-ranging, comprehensive review includes discussion of epidemiology, pathophysiology, clinical consequences and management of metabolic acidosis. The authors distinguish acute metabolic acidosis (lasting hours/days) from the much less common, chronic metabolic acidosis, which can last for years. Acute metabolic acidosis is a common feature of serious illness; a study quoted in the re Continue reading >>

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  1. red_reader

    Neonatal ketosis -

    Neonatal ketosis -
    Suckling Ketogenesis (Williams, 1997)
    After normal blood glucose decline in first 3 hours, brisk ketogenic response in breastfed infants
    Ketone bodies provide alternative energy source for neonatal brain
    Breastfed babies tolerate lower blood glucose levels because their ketone body levels are elevated
    LGA infants of non-diabetic mothers will mount a sufficient ketogenic response to low blood sugar levels Link to PDF I realize this is not an actual study. I am looking for those specific references.
    Babies are in deep ketosis at birth and continue to be so until they are weaned off breast milk. I haven't looked to see how fast that decline out of ketosis happens after babies are weened off breast milk.
    Link to a list of scientific studies
    This leads me to believe that being in ketosis is actually the natural state, and out of ketosis is a result of excessive carbs ... ( crap your body doesn't need )

  2. bollockitis

    This leads me to believe that being in ketosis is actually the natural state, and out of ketosis is a result of excessive carbs ... ( crap your body doesn't need )
    The research is interesting, but I don't think it warrants that conclusion. Using that logic, you could say that because babies drink only breast milk, drinking breast milk is the natural state and eating anything else is unnatural.

  3. red_reader

    My conclusion is slightly different. Since breast milk is so high in fat ( causing the ketosis ) I feel that our natural diet should consist of high fat. Of note is that as soon as babies are taken off of breast milk and placed on ( man made ) formula, they fall out of ketosis.

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