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Renal Tubular Acidosis

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What is renal tubular acidosis (RTA)? RTA is a type of metabolic acidosis caused by the kidneys failure to properly acidify the urine. Find more videos at http://osms.it/more. Study better with Osmosis Prime. Retain more of what youre learning, gain a deeper understanding of key concepts, and feel more prepared for your courses and exams. Sign up for a free trial at http://osms.it/more. Subscribe to our Youtube channel at http://osms.it/subscribe. Get early access to our upcoming video releases, practice questions, giveaways and more when you follow us on social: Facebook: http://osms.it/facebook Twitter: http://osms.it/twitter Instagram: http://osms.it/instagram Thank you to our Patreon supporters: Sumant Nanduri Omar Berrios Alex Wright Sabrina Wong Suzanne Peek Arfan Azam Mingli Fng Osmosis's Vision: Empowering the worlds caregivers with the best learning experience possible.

Renal Tubular Acidosis - General Practice Notebook

The whole terminology of renal tubular acidosis can be confusing to the newcomer. Important features to grasp are: The acidosis refers to the plasma, not the contents of the renal tubules. Indeed, in classical (type I) renal tubular acidosis the urine is often alkaline. Thus renal tubular acidosis is a metabolic acidosis of renal tubular origin. There are three main types, named I, II and IV. Type III has become obsolete. The three types have different sites of localisation in the renal tubule. However, again the terminology is confusing in that type II is proximal, type I distal. Home| About us| Facebook| Contact us| Authors| Help| FAQ This site is intended for the use of healthcare professionals only. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions. Copyright 2016 Oxbridge Solutions Ltd. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions Ltd receives funding from advertising but maintains editorial independence more... GPnotebook stores small data files on your computer called cookies so that we can recognise you and provide you with the best service. If Continue reading >>

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Popular Questions

  1. xenia

    I have a few questions about a ketogenic diet.
    1) Lately, I have probably been eating less than 50 grams of carbs a day. Is this ketogenic?
    2) If someone is on a ketogenic diet, does this require urine testing at home? Is this suggested or necessary? Do you?
    3) Are there known risks for being on a severely carb restricted diet that one should be aware of?
    I seriously dont want to "hassle" with counting carbs, so I've thought to myself I will cut out the obvious ones then I wont have to count. Most recently, I've eliminated breads, rice, pototoes, sweets, and only eat carbs that end up in nuts, yogurt, low carb veggies, berries, etc. So based on that I am guessing that I eat 60 g of carbs a day, or less. Possibly much less on many days.
    Today for breakfast, I had scrambled eggs with sauteed peppers, and chedder cheese.
    Lunch was a small bowl of broccoli cheddar soup, with less than 10 grams of carbs (per the container)
    Supper was a 7 oz hamburger with about 3/4 cup strawberries. It was an early supper so I will have some Greek yogurt with nuts or something later.
    How does that sound?
    Yesterday, for breakfast I had a chocolate protein drink and 3 brazil nuts
    Lunch - turkey lunch meat, a couple slices of cheddar cheese, and a big handful of grape tomatoes.
    Now here is the clincher: For supper, I made some homemade "chicken pot pie mixture" and I didnt have it with the biscuit on top. I knew that I put flour in there, to thicken the sauce, and peas and carrots with carbs. I knew it was not a pristine choice (my husband couldnt stop raving, of course) I think it was the "Pizza Effect" I've heard about through this support community, as my BG didnt rise too much immediately after that - 118 at one hour, and 96 at two hours I was shocked, actually. But when I went to bed, it was 128! (I realize that it could have risen, "just because" as well.) For me, at that hour, that was a lot. And then all day today, higher than normal, even with low carb eating and a 30 minute walk.
    So I feel like I HAVE to basically eliminate most carbs from my life to maintain AS NEAR TO NORMAL NUMBERS AS POSSIBLE - is my goal. My ideal would be most of the day, under 100. Which means a very low carb, or ketogenic ? diet.
    Which is why I need to know more, from your perspective, about this diet. I LOVE my doctor, he's the greatest, but he is still suggesting 40 g of carbs at each meal. We've had plenty of discussion about that mindset. My dietician, too.
    So what do YOU think about a ketogenic diet - its safety, whether you need to test your urine for ketones, what numbers of carbs actually constitute a ketogenic diet? Does what I am doing sound like a ketogenic diet (minus the pot pie, no biscuit?)

  2. lowcarbwalking

    Hi Xenia,
    Here is my experience with doctors and a ketogenic diet:
    1. Internal medicine doctor who diagnosed me with diabetes:
    She had one patient who used the Keto eating method and it worked/s for him. She did not know enough about it to tell me how to do a ketogenic diet. She said, find info on the the web or get a book.
    2. My longtime endocrinologist:
    WHAT!?! A Keto Diet, that will make you sick. Very bad idea, don't do it, I don't recommend it.
    3. What I did:
    Read the book, "Art and Science of Low Carbohydrate Eating" and Dr Bernstein's book, " Diabetes Solution". Both were in my local library.
    4. MY RESULT: Stayed on a Keto diet for 18 months. Lost 72 pounds without counting calories. BLood glucose numbers returned to normal. Have had normal range a1c's for last 6.5 years eating 50-70 grams of carb a day. 50-70 grams a day of carb does not put me into the Keto range.
    5. Last Visit with the ENDO who told me KETO was a bad idea:
    Saw my Endocrinologist this past Monday. She praised me highly for another A1c in the normal range and fasting blood glucose test in normal range. She says she does not consider me to have diabetes any longer and writes in my chart each time I see her: No clinical evidence of diabetic disease
    I have Keto test strips but only use them when I am ill to check to see if I have ketones and need to go to urgent illness for rehydration and anti nausea medication
    Different people get to the stage of having ketones at different levels of low carb eating. It depends on your body size, activity level,and possibly other medical conditions. Most women will not be in the Keto range at 50 plus grams of carb. Most people will be in Keto range if they eat a total of 20-30 grams of carb a day. It takes a few days to maybe a week of eating very low carb to attain Keto range.
    There are a number of closed Facebook groups you can join that are all about the Keto way of eating.
    More and more doctors and other medical professionals are coming around to using low carb including Keto diet as a recommendation for people with diabetes.
    There are and have been a number of poeple on this forum over the years that have done Keto or are doing Keto.

  3. maryd98

    I've read quite a few posts here from different people who've either tried a keto diet or who follow it regularly. I've never done it myself, but it seems to work for some people.
    Personally, I feel like the more 'balanced' I can make my meals/snacks, the more I'm able to stick with the plan over the long haul. I don't like the idea of cutting out any food group --or even any particular foods--except the ones I don't like! I do avoid dairy, because I'm lactose intolerant, but I have things like soy milk and vegan/veggie/nut cheese. If I have regular dairy, I get sick, so it's easy to cut that out.
    I focus on my BG trends and patterns more than on specific numbers on specific days. I do not try to maintain non-diabetic BG numbers 100% of the time. Still, the goals I've set are attainable and have kept me in good health; after living with T2 diabetes for 18+ years, I manage it without meds and have no signs of compications (knock on wood!).
    We each have to find our own way to live with diabetes and manage it so that we avoid complications. I would not advise anyone to follow a ketogenic diet, but like I said, I have read of people who do follow it, and they seem to be happy with it. I've read some negative comments, too, by some who've tried it. There's no single plan that works for everyone with T2 diabetes.
    I wish you good luck and good health as you continue on your journey!

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Renal Tubular Acidosis (rta)

By L. Aimee Hechanova, MD, Assistant Professor of Medicine, Texas Tech University; Attending Nephrologist, University Medical Center (See also Introduction to Disorders of Kidney Tubules .) In renal tubular acidosis, the kidney tubules malfunction, resulting in excess levels of acid in the blood. The tubules of the kidneys that remove acid from the blood are damaged when a person takes certain drugs or has another disorder that affects the kidneys. Often muscle weakness and diminished reflexes occur when the disorder has been present for a long time. Blood tests show high acid levels and a disturbance of the body's acid-base balance. Some people drink a solution of baking soda every day to neutralize the acid. To function normally, body acids and alkali (such as bicarbonate) must be balanced. Normally, the breakdown of food produces acids that circulate in the blood. The kidneys remove acids from the blood and excrete them in the urine. This function is predominantly carried out by the kidney tubules . In renal tubular acidosis, the kidney tubules malfunction in one of two ways that tend to increase acids in the blood ( metabolic acidosis ): Too little of the acids the body produc Continue reading >>

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Popular Questions

  1. allyfco

    Been having a lot of tingling sensations in calves, feet, forearms, and hands the past few days... I've never had this before and it's only started recently here in my second month of keto... it doesn't make sense to me that I would have an appearance of diabetic neuropathy after going well into keto & fat adaptation, when I'd never had it before... what do you think? Electrolyte issue possibly? Has anyone experienced this? It's starting to freak me out a bit... Thank you!

  2. turbeville

    I would definitely see your doctor. It could be electrolyte related or something else entirely.

  3. JorgePasada

    I'd hit the big three. Sodium, Magnesium and Potassium. Probably 3 grams 500mg and 500mg respectively. Bonus points if your magnesium suplement has calcium in it.

    If the feeling persists after 8 hours or if it's continuous not intermitent, get to a doctor. I got this feeling occasionally on and off over the last couple months but I haven't eaten in 54 days.

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This is a review of the pathophysiology, diagnosis and treatment of Renal Tubular Acidosis intended for 3rd and 4th year medical students and others learning clinical medicine.

Renal Tubular Acidosis

Renal tubular acidosis (RTA) is a disease that occurs when the kidneys fail to excrete acids into the urine, which causes a person's blood to remain too acidic. Without proper treatment, chronic acidity of the blood leads to growth retardation, kidney stones, bone disease, chronic kidney disease, and possibly total kidney failure. The body's cells use chemical reactions to carry out tasks such as turning food into energy and repairing tissue. These chemical reactions generate acids. Some acid in the blood is normal, but too much acidacidosiscan disturb many bodily functions. Healthy kidneys help maintain acid-base balance by excreting acids into the urine and returning bicarbonatean alkaline, or base, substanceto the blood. This "reclaimed" bicarbonate neutralizes much of the acid that is created when food is broken down in the body. The movement of substances like bicarbonate between the blood and structures in the kidneys is called transport. One researcher has theorized that Charles Dickens may have been describing a child with RTA in the character of Tiny Tim from A Christmas Carol. Tiny Tim's small stature, malformed limbs, and periods of weakness are all possible consequence Continue reading >>

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  1. CabinFeverBob

    I've been reading that caffeine stimulates an overproduction of insulin, which ultimately hinders weight loss and/or promotes weight gain. Has anyone found that they lose more weight when eliminating caffeine from their diet?
    I hate to say it, but I think I'm about ready to resort to eliminating my beloved caffeine, to see if that could be my problem. I drink over a pot of coffee every day.

  2. Arcygenical

    Any increase in insulin production is quickly and easily offset by the drastic reduction in insulin sensitivity caffeine imparts in it's half-life and metabolically active window.
    It should be noted that GLUT4 receptors, on muscle cells, are not hindered by this decrease in sensitivity post workout... Which means that careful caffeine timing can actually help make sure your muscles recover properly, and that your body shunts available, circulating carbohydrates to areas you want - such as your muscles - and not areas you don't, like fat stores.
    Caffeine, though, can drastically increase cortisol, so yes, if you're a super stressed person, it's possible that caffeine can change the way your body stores fat.

  3. billsil

    drastic reduction in insulin sensitivity caffeine imparts
    Which is true, but coffee is not caffeine
    coffee is linked to lower body weight and protection from type 2 diabetes. Heck, heavy coffee drinking is even linked to protection against non-alcoholic fatty liver disease, (there are pubmed sources for these claims at the link)
    Read more: http://www.marksdailyapple.com/coffee-and-insulin-fat-and-post-workout-meals/#ixzz2thM1RzQ0
    As you said, if you're a super stressed out person, you should cut it. However, a little bit of stress will actually make you feel better.

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