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Renal Tubular Acidosis Diagnosis Criteria

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For just $1/month, you can help keep these videos free! Subscribe to my Patreon at http://www.patreon.com/pwbmd Minor correction: At about 12:30, I referred to furosemide as a thiazide diuretic. It of course is not; it's a loop diuretic. Thiazide diuretics would include such drugs as hydrocholorothiazide. (Disclaimer: The medical information contained herein is intended for physician medical licensing exam review purposes only, and are not intended for diagnosis of any illness. If you think you may be suffering from any medical condition, you should consult your physician or seek immediate medical attention.)

Renal Tubular Acidosis | The Online Metabolic And Molecular Bases Of Inherited Disease | Ommbid | Mcgraw-hill Medical

Renal tubular acidosis (RTA) is a clinical syndrome characterized by hyperchloremic metabolic acidosis secondary to an abnormality in renal acidification. The acidification defect may be manifested by an inappropriately high urine pH, bicarbonaturia, and, by definition, reduced net acid excretion. Classical distal renal tubular acidosis and proximal renal tubular acidosis are frequently associated with hypokalemia. Distal renal tubular acidosis can also result from a generalized dysfunction of the distal nephron, in which case it is usually accompanied by hyperkalemia and may be associated with either hypoaldosteronism or aldosterone resistance. Proximal renal tubular acidosis may result from an isolated defect of acidification in the proximal nephron. The isolated defect in acidification could be the result of selective dysfunction of the Na+/H+ antiporter, the proximal tubule H+-ATPase or the Na+/HCO3 /CO3 = symporter. More commonly, proximal renal tubular acidosis occurs as one manifestation of a generalized defect in proximal tubule function. Patients with this generalized abnormality, the Fanconi syndrome, usually have glycosuria, aminoaciduria, citraturia, and phosphaturia. Continue reading >>

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  1. Equinox

    Hello, I am on day 17 of the Whole30, which I started in an attempt to get my rosacea under control. I am also interested in weight loss. Anyway, I can say that my pants are fitting a little looser since I started and my rosacea is better than it has been in a long time. So far I have tried to be as compliant as possible and my only two slips were accidental. I ate a sausage that had red wine on the ingredient list (I forgot that wine isn't allowed as I don't drink alcohol at all so I didn't register that part of the book as applying to me and just skimmed over it!). I also accidentally grabbed my daughter's glass instead of mine and got a small sip of lime-ade before I could spit it out. Those were in the first week though. I didn't bother starting again on Day 1 with these as I plan to be on the Whole30 for more than 30 days and counting things annoys me.
    On the other hand, my menstrual cycle (which arrived about 10 days in) was both heavier and longer than normal and I had terrible insomnia for a week beforehand. After my cycle began this eased off somewhat but I still have trouble falling asleep, staying a sleep and also with waking up too early. I feel like a zombie and I'm averaging about 5 hours of poor quality sleep a night. I've had to stop my regular exercise routine as I'm just too tired. I should mention that I'm usually a good sleeper, except when my daughter wakes me up in the night, which unfortunately happens a couple of times a week these days. And that happened more than the usual number of times in the past two weeks so my sudden insomnia has been all the worse. This is seriously the worst quality sleep I have ever gotten in my life that was not caused by some external factor (like having a newborn). I just toss and turn and feel really anxious over nothing at all.
    It seems that some other people have experienced this with the Whole30 as well. I'm wondering if I've entered into ketosis, which I read was associated with insomnia in some people, especially women. I just weighed myself to see if I had any sort of profound weight loss that might explain it and it seems I've lost 4 lbs, which is more than usual for me but certainly not beyond the pale. So, assuming that I have not been eating enough starch (I've been trying to eat a starchy vegetable once a day and eating a banana once a day also), how long will it take to get out of ketosis if I start adding a starchy vegetable to each of my three meals? I should add that even though I maybe haven't been getting enough starch, I haven't been hungry at all and I didn't experience any cravings at all until the sleep deprivation started to kick in. Also, has anyone had success with melatonin?
    I just really want to get a good night's sleep.

  2. missmary

    I would not recommend melatonin as a long-term solution because it interferes with your bodies ability to produce melatonin on it's own. Magnesium is a great supplement that can help with sleep.
    If you already have included starchy veggies and bananas every day, ketosis is very unlikely. Regardless, starchy veggies can certainly help with sleep and anxiety issues, especially when consumed at meal #3. How is your fat intake? Make sure you keep that at least to the minimum recommended 1-2 thumbs per meal (don't rely on cooking fat alone, since much of that stays in the pan).
    Eating within an hour of waking and also getting sunlight right away in the morning (go outdoors for 15 minutes) can really help with getting cortisol in the right rhythm which will help with sleep. In the same vein, avoiding bright light and screens at night will also help keep circadian rhythms in proper order. Some people use amber glasses or software like f.lux to reduce blue light at night for a similar effect.
    Good luck. I hope you get some better sleep soon!

  3. Tom Denham

    I am one of those people who needs starchy veggies every day to keep me sleeping good. I've also had a great experience with taking magnesium. I used to take Natural Calm, but it provoked diarrhea for me. I switched to magnesium aspartate supplements - 200 to 300 mgs per night. It is working very well. Actually, when I first saw a functional medicine doctor, she gave me an injection of magnesium and I enjoyed great sleep that night and for the next several nights.

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Bala Venkatesh (University of Queensland, Australia) busting lactate myths at #SGANZICS on 22 April 2017. Mark your calendar for SGANZICS 17-21 May 2018!

Renal Tubular Acidosis Is Highly Prevalent In Critically Ill Patients

Renal tubular acidosis is highly prevalent in critically ill patients Brunner et al.; licensee BioMed Central.2015 Hyperchloremic acidosis is frequent in critically ill patients. Renal tubular acidosis (RTA) may contribute to acidemia in the state of hyperchloremic acidosis, but the prevalence of RTA has never been studied in critically ill patients. Therefore, we aimed to investigate the prevalence, type, and possible risk factors of RTA in critically ill patients using a physical-chemical approach. This prospective, observational trial was conducted in a medical ICU of a university hospital. One hundred consecutive critically ill patients at the age 18, expected to stay in the ICU for 24h, with the clinical necessity for a urinary catheter and the absence of anuria were included. Base excess (BE) subset calculation based on a physical-chemical approach on the first 7days after ICU admission was used to compare the effects of free water, chloride, albumin, and unmeasured anions on the standard base excess. Calculation of the urine osmolal gap (UOG) - as an approximate measure of the unmeasured urine cation NH4 + - served as determinate between renal and extrarenal bicarbonate los Continue reading >>

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  1. Breimann

    Hi everyone! I'm back on keto! ... again! Yay. However, while I am kinda hefty (5'7, 207lb as of six days ago), my weight is not the main factor for the change.
    A few weeks ago I had my checkup with my primary care doctor. For the second visit in a row my blood pressure was high. 160/90 to be exact. He mentioned the idea of a mild blood pressure medication.
    Folks, my mother takes a friggin pill cocktail twice a day. Blood pressure, cholesterol, heart meds, insulin, you name it. My pops isn't much better.
    "Doc" I said, "I'm 28 man, I can't depend on a medication this soon unless it's life threatening. Please, you've known me 20 years, trust me enough to turn it around. If I can't, then we can talk the possibility of meds."
    He agreed. He suggested cutting back on caffeine and sodium. So I did. From two large iced coffees from Dunkin full of caramel swirly shit to one medium with cream and one Sweet n Low. Eggs and Turkey for breakfast instead of a hungry man (3 eggs, bacon ham sausage and potatoes on a hero for the unfamiliar).
    I WAS MISERABLE FOR DAYS. My work was suffering (i do light construction) and felt like death at the gym. Then one of my coworkers, who I converted to Keto a while back simply suggested i cut out the carbs again. Duh, water retention.
    So here I am, with a wife who is baffled by the fact that my single meal today was two cans of tuna, three eggs, half a block of cheddar, two scoops of peanut butter and some pork rinds. I already feel better overall - more energy at work, moving better at the gym... I have yet to weigh myself or check my blood pressure. I go back for a checkup in three weeks and I'm actually really excited to see what results may come.
    It feels good to be back. <3

  2. xanderbitme

    8 months ago I was on the maximum dose of Tenormin. Two weeks ago I was finally able to eliminate it. 50 lbs loss was all it took (still have 30 to go).

  3. bidnow

    Mine went from
    150/100 > 120/84
    39.2 BMI > 27.8 BMI
    27.8 BMI is 177 lbs for you. Good luck

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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.

Distal Renal Tubular Acidosis

I do not know why anyone would diagnose distal RTA (dRTA) very often. As I will show you it has colorful and unusual characteristics as unmistakable as rare, so diagnosis is not difficult. But many more people think they have than have it. In my 50 years of kidney stone prevention I have perhaps a few dozen examples or so, out of many thousands of stone formers. This is another of those long, elaborate articles only the most devoted read. Even so, elaborate as it is, this article tells only part of the story. It simplifies or simply ignores the mechanism for low potassium in dRTA, and left for another time its genetic causes, and also the bone and mineral disorders and treatment outcomes. I forgive myself, as just this part has been most taxing to write and is equally so to read. In a subsequent article I hope to expand on diagnosis and treatment, the bone and mineral disorders, genetic transporter disorders, and take up the novel modern issue of acid retention and its effects on kidneys. So consider the present article a part of my planned contribution. The featured illustration of kidney tissue from a patient with dRTA shows many crystal deposits on a radiograph (panel a), that Continue reading >>

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  1. Pistolfist

    I want to check with the community as I can't find too much information, the general consensus I can find from google is don't have sugar because sugar is a carb and carbs are anti-ketogenic, but I knew this already.
    But say hypothetically, it's a friday and I have friends round, I've had 2g of carbs in my day so far and I decide to get the tumblers out and make a couple of old fashioneds, I weigh the sugar out to be no more than 8g (of course, I don't think I need to worry about the other ingredients - whisky, angostura bitters and water), say I have two of these that's 16g of sugar. So even if the sugar is 100% carb, I'm still only on an 18g total for my day which is less than my 20g target - is this still going to kick me out of keto?
    I'm just curious because I do love an old fashioned and it's not a sweet drink despite the sugar so I don't know about the insulin response here?
    In short, even if I am below 20g of carbs, can I still not have any sugar?

  2. Pistolfist

    I've been making old fashioneds with stevia and they still taste pretty good!
    I had intended on asking a whisky/whiskey/alcohol related subreddit the question, if an old fashioned still worked with stevia (I mean, you must need like this absolute tiniest amount, right?) but I couldn't think of a decent sub to ask it, I'm only subscribed to /r/whisky and I don't imagine mentioning a cocktail would go down there. I will definitely give it a try though!

  3. RefindingMe

    It's certainly not the best idea to get your day's worth of carbs from straight up sugar, as you should try for natural vegetable sources.
    But if every now and then, you want to let loose with your buddies, it's fine as long as it's the rare exception and not the rule. That many carbs at once may throw you out of ketosis momentarily, but as long as you get back to eating properly as quickly as possible, you should be fine.
    I should point out that if you're still just starting, this will really screw up keto adaptation, so try and wait a month or two before doing this. Your gut will thank you.

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