Renal Tubular Acidosis Type 4

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Korean Journal Of Pediatrics :: A Case Of Type Iv-4 Renal Tubular Acidosis

Korean J Pediatr 1997 November;40(11) :1603-1607. A Case of Type IV-4 Renal Tubular Acidosis Department of Pediatrics, Catholic University Medical College, Seoul, Korea Copyright 1997 by The Korean Pediatric Society Type IV renal tubular acidosis(RTA) is due to renal tubular bicarbonate wastingassociated with mineralocorticoid deficiency. In its five subtypes, IV-4 is due topseudohypoaldosteronism(PHA) evidenced by increased plasma renin and aldosterone.PHA is believed to result from distal tubular unresponsiveness to circulating aldosteroneand has normal renal and adrenal fuction.Hypoaldosteronism can easily be suspected when the patient shows typical electrolyteimbalance (hyponatremia coupled with hyperkalemia) and the diagnosis of PHA isconfirmed by elevated serum aldosterone level. But some patients of PHA shownegligible electrolyte imbalance, thus metabolic acidosis is a sole abnormal finding inroutine laboratory examination.We experienced a case of IV-4 RTA in a 2-month-old male infant who presentedwith normal anion gap-metabolic acidosis as a sole abnormal finding in routine laboratoryexamination. RTA was suspected and the test of urine pH during systemic acidosis andfracti Continue reading >>

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  1. MariaMia816

    Can anyone tell me what an average weight loss per week or month is for 20 carbs a day? Im loosing soooooo slow.

  2. GSD_Mama

    I guess it will be different for everyone. My first two weeks I've lost about 10, of which water was probably 5-7lb. I'm going on my third month now and losing slow, sometimes I gain sometimes I lose, no rhyme or reason.

  3. stevieedge2015

    10lbs in a month. I'm trying to keep my calories to under 1500. I smoke like a chimney though so...aiming to get to 130 so I can quit and not worry about gaining 10lbs

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Kegg Disease: Hyperkalemic Distal Renal Tubular Acidosis (rta Type 4)

Hyperkalemic distal renal tubular acidosis (RTA type 4) Renal tubular acidosis (RTA) is characterized by metabolic acidosis, a severe disturbance of extracellular pH homeostasis, due to renal impaired acid excretion. Type 4 RTA is a heterogeneous group of disorders associated with hyperkalemia due to aldosterone deficiency or impairment in aldosterone molecular signaling. Primary pseudohypoaldosteronism type 1 (PHA1) is characterized by salt-wasting, hyperkalemia, and metabolic acidosis in the presence of markedly elevated plasma renin activity and aldosterone concentration. In the autosomal dominant form, aldosterone resistance is due to heterozygous mutations in the mineralocorticoid receptor gene. In the autosomal recessive form, aldosterone resistance is caused by loss-of-function homozygous mutations in the genes encoding one of the three constitutive subunits (alpha, beta, and gamma) of the epithelial Na+ channel (SCNN1A, SCNN1B, and SCNN1G). Other inherited cause of type 4 RTA includes hyperkalaemia associated with hypertension and low or normal levels of plasma aldosterone. This syndrome is called pseudohypoaldosteronism type 2 (PHA2), or Gordon's syndrome, which results i Continue reading >>

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  1. JonnyV

    How long does it take you guys to get into ketosis after a cheat day? It seems like when I do a 4HB-style cheat day on Saturday, I don't get back into ketosis until Thursday night. This sucks, because I only have a day or two in ketosis before another cheat day.
    Do you guys get into ketosis faster when doing a carb refeed like Dave does?
    Should I just do a cheat day or carb refeed every 2 weeks?

  2. Skeletor

    Go a little heavier on the MCT oil/ Coconut oil. It should help speed up ketone production. Also go lower carb a day or two after such an event.
    Moreover, ditch the cheat days and save yourself the trouble

  3. bjjcaveman

    It takes me anywhere from 2-4 days depending on how heavily I work out in between.

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Inspired by Dr. Myat Soe, MD Renal Tubular Acidosis: Type 2 Internal Medicine Series: Clinical Clerkships Made with help of Blueberry Flashback Recorder

Tacrolimus-induced Type Iv Renal Tubular Acidosis Following Liver Transplantation

Tacrolimus-Induced Type IV Renal Tubular Acidosis following Liver Transplantation 1Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA 2Department of Internal Medicine, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA Correspondence should be addressed to Christopher Schmoyer ; [email protected] Received 15 April 2017; Accepted 1 June 2017; Published 6 July 2017 Copyright 2017 Christopher Schmoyer et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Calcineurin inhibitors remain an integral component of immunosuppressive therapy regimens following solid organ transplantation. Although nephrotoxicity associated with these agents is well documented, type IV renal tubular acidosis is a rare and potentially underreported complication following liver transplantation. Hepatologists must be able to recognize this adverse effect as it can lead to fatal hyperkalemia. We describe a case of tacrolimus-induced hyperkalemic type IV renal tubular acidosis in a patient Continue reading >>

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  1. marcustomp

    The ketogenic diet (often referred to as “keto”). Today I speak about my keto experience and the basics of a ketogenic diet.
    What is the ketogenic diet?
    I’m no stranger to self-experimenting, playing around with my diet and trying to optimise my nutrition. I’ve been practising intermittent fasting for nearly 4 years now, but there’s a specific diet i’ve been meaning to try - the ketogenic diet.
    Firstly for those who don’t know the ketogenic diet is a low-carb, high fat diet (LCHF) with many health benefits.
    It involves drastically reducing carbohydrate intake, and replacing it with fat. The reduction in carbs puts your body into a metabolic state called ketosis.
    When this happens, your body becomes incredibly efficient at burning fat for energy. It also turns fat into ketones in the liver, which can supply energy for the brain.
    Ketogenic diets can cause massive reductions in blood sugar and insulin levels. This, along with the increased ketones, has numerous health benefits, such as: the potential to fight against diabetes, epilepsy, Alzheimer’s disease and even cancer.
    There are also four different classifications of the ketogenic diet. The standard ketogenic diet is accepted as reducing your carbohydrates intake to 5% carbs, with just enough protein (20%, let’s say) and the rest coming from fats.
    The basic principle around ketogenic diets is that our bodies first port of call for energy are carbohydrates or glucose. Think about a fridge, the fridge is analogous to carbohydrates because they’re easy to access. Then we have the freezer, equivalent to fat, it’s more difficult to access, as we have to bend down or walk to the basement. The flip side is that there’s more energy in there. #Classifications
    Other classifications of ketogenic diets are higher protein, or more advanced models like targeted kept which is manipulating carbohydrate consumption around workouts so that one has greater athletic performance and potentially a greater ability to gain muscle (as this is one aspect of your body composition which is harder to progress in).
    There is also cycling ketogenic, or carb-cycling which is just alternative days of ketogenic dieting, but for now we’re sticking to the standard model.
    Dietary restrictions:
    The basis of ketogenic diets are avoiding carbohydrates and yes this includes fruit.
    Foods you should avoid:
    Avoid carb-based foods like grains, sugars, legumes, rice, potatoes, candy, juice, alcohol, unhealthy fat and even most fruits
    Foods you should eat:
    Base the majority of your diet on foods such as meat, fish, eggs, butter, nuts, cheese, full-cream (no-milk) healthy oils, avocados and plenty of low-carb veggies.
    Side effects:
    Keto-flu. As your body is adapting you may find yourself with flu like symptoms (ket-flu)
    Fatigue, lethargy, urine smell, breathe smell, constipation
    Many doctors recommended added salt when starting out as your body adjusts.
    Magnesium is also important.
    Increase your fibre intake, eat a lot of spinach and other green vegetables as well as plenty of water (not too much)
    You can also purchase exogenous ketones which kick-start the state of ketosis in the body, but I think this is unnecessary for someone just beginning.
    Remember that a caloric deficit is always required for weight loss to actually occur.
    In terms of alcohol, small amounts of red wine can be acceptable on the diet, or hard liquors (which of course I don’t recommend).
    Eating out. Simply order a normal meal but replace the carbohydrates with extra vegetables.
    Foods I’ve been eating.
    90% chocolate Almonds A lot of salmon. Occasional grass-fed steak Olive oil Olives Grass-fed butter, Spinach Mixed green vegetables
    My personal experience (WEEK 1)
    I think my experience has been very smooth; for one I made sure to slowly reduce the amount of carbohydrates in my diet in the previous week in order to not “shock” the body.
    I’ve also been practising intermittent fasting for years, which is essentially a close cousin of ketogenic diets and mimic some of the effects.
    For the first two days I felt a little fatigued, but after the third day I found my cognitive processing to increase greatly.
    Another point is that I think i’m going to have to reduce my fasting windows to something less extreme so I can actually consume to appropriate amount of calories.
    I’m not trying to lose weight, I’m using the ketogenic diet simply to self-experiment and see if my body, but more specifically, mind prefers it for being more productive and focused.
    Concluding points:
    But it’s a great diet for losing weight, firstly of course because of the reduced insulin levels, but also for other reasons such as increased protein intake and increased fibre which are going to help you reduce your appetite.
    If you are losing weight combining this with intermittent fasting is an incredibly powerful formula one could say to drop weight quickly.
    Overall it’s been interesting so far. I’m really excited to see how this plays out as it’s something I’ve wanted to do for a long time.
    All the best.

  2. mallardcove

    So you have done it for one week and felt the need to write a post about it? I'd have stuck at it a little longer.
    Personally I think keto is fine if your goal is strictly to lose weight, but if you are trying to add muscle/strength it's not optimal.

  3. leonardo_vetra

    Agreed - a week is barely enough to get past the carb withdrawals and start feeling the benefits of becoming fat adapted. The weight dropped is likely just water weight from ceasing to eat so much processed food.

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