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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
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
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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
What is respiratory acidosis? Respiratory acidosis is a condition that occurs when the lungs can’t remove enough of the carbon dioxide (CO2) produced by the body. Excess CO2 causes the pH of blood and other bodily fluids to decrease, making them too acidic. Normally, the body is able to balance the ions that control acidity. This balance is measured on a pH scale from 0 to 14. Acidosis occurs when the pH of the blood falls below 7.35 (normal bl ...
Metabolic acidosis occurs when the body produces too much acid. It can also occur when the kidneys are not removing enough acid from the body. There are several types of metabolic acidosis. Diabetic acidosis develops when acidic substances, known as ketone bodies, build up in the body. This most often occurs with uncontrolled type 1 diabetes. It is also called diabetic ketoacidosis and DKA. Hyperchloremic acidosis results from excessive loss of s ...
Jeffrey A. Kraut, MD is Chief of Dialysis in the Division of Nephrology at the Greater Los Angeles Veterans Administration Healthcare System, Professor of Medicine at the David Geffen School of Medicine at UCLA, and an investigator at the UCLA Membrane Biology Laboratory, Los Angeles, CA, USA. He completed his nephrology training at the TuftsNew England Medical Center where he performed basic research examining the mechanisms regulating acid exc ...
Acid-Base Physiology Buffers H+ A- HCO3- CO2 Buffers H+ A- CO2 Cells Blood Kidney Lungs Fluids, Electrolytes, and Acid-Base Status in Critical Illness Blood Gas Analysis--Insight into the Acid-Base status of the Patient The blood gas consists of pH-negative log of the Hydrogen ion concentration: -log[H+]. (also, pH=pK+log [HCO3]/ 0.03 x pCO2). The pH is always a product of two components, respiratory and metabolic, and the metabolic component is ...
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 bre ...
Respiratory alkalosis is a medical condition in which increased respiration elevates the blood pH beyond the normal range (7.35–7.45) with a concurrent reduction in arterial levels of carbon dioxide. This condition is one of the four basic categories of disruption of acid–base homeostasis.[medical citation needed] Signs and symptoms Signs and symptoms of respiratory alkalosis are as follows: Palpitation Tetany Convulsion Sweati ...