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Renal Tubular Acidosis Workup

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Inspired by Dr. Ritika Vankina, MD Renal Tubular Acidosis, Type 1: Overview of classification and pathophysiology Video recorded with help of Blueberry Flashback Player

Type 4 Renal Tubular Acidosis

Aka: Type 4 Renal Tubular Acidosis, Type IV Renal Tubular Acidosis, Type IV RTA, Hyperkalemic RTA, Hyperkalemic Renal Tubular Acidosis Creatinine Clearance decreased (<45 ml/min) Low dose Oral Sodium Bicarbonate (1-2 meq/kg/day) Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Type 4 Renal Tubular Acidosis." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images Related Studies (from Trip Database) Open in New Window Related Topics in Acid and Base Disorders FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6557 interlinked topic pages divided into a tree of 31 specialty books and 722 chapters. Content is updated monthly with systematic literature reviews and conferences. Although access to this website is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians. This page was written by Scott Moses, MD , last revised on 10/21/2007 and last pub Continue reading >>

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Popular Questions

  1. DoomPirate1

    What's the Oily Stuff in my Urine?

    When I urinate, this oily stuff sinks to the bottom. Not milky or cloudy at all. Does anyone know what this stuff is? Urine pretty standard yellow color, sometimes deeper yellow. And when it is this deeper yellow, I seem to urinate more amounts of this oily stuff.
    I've been averaging sub-50g carbs daily for about 2 months, Primal for 10 months. Protein accounts for maybe 30-40% of my daily calories. And I can now operate very well with little to no carbs, with high fat and protein intake. I've been losing a pound of fat per week, so everything is going very nicely.The keto sticks have been registering trace and very low still. (occassionally moderate)
    Background: Male, age 24, i take fishoil supplements, eat fish occassionally, I take Life Extension Mix Multivitamins, creatine, bcaa's.

  2. Vivvid

    Go see a doctor. (and maybe your gf as well)

  3. DoomPirate1

    Originally Posted by Vivvid
    Go see a doctor. (and maybe your gf as well)

    But I am more heathy than i have ever been. Just had a 10lb Deadlift PR. 405lb at 152. I feel great.
    I think its something normal, I am just curious what it is. It is not globs of this "oily substance", its small amounts.
    Its not an STD... I would know. No GF

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

Metabolic Acidosis Workup: Approach Considerations, Laboratory Evaluation, Complete Blood Count

Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN more... Often the first clue to metabolic acidosis is a decreased serum HCO3- concentration observed when serum electrolytes are measured. Remember, however, that a decreased serum [HCO3-] level can be observed as a compensatory response to respiratory alkalosis. An [HCO3-] level of less than 15 mEq/L, however, almost always is due, at least in part, to metabolic acidosis. The only definitive way to diagnose metabolic acidosis is by simultaneous measurement of serum electrolytes and arterial blood gases (ABGs) , which shows pH and PaCO2 to be low; calculated HCO3- also is low. (For more information, see Metabolic Alkalosis .) A low serum HCO3- and a pH of less than 7.40 upon ABG analysis confirm metabolic acidosis. Go to Pediatric Metabolic Acidosis and Emergent Management of Metabolic Acidosis for complete information on these topics. The diagnosis is made by evaluating serum electrolytes and ABGs. A low serum HCO3- and a pH of less than 7.40 upon ABG analysis confirm metabolic acidosis. The anion gap (AG) should be calculated to help with the differential diagnosis of the metabolic acidosis Continue reading >>

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Popular Questions

  1. bbearsmama

    Ketones found in urine-is our diet bad for our kidneys?

    Hi there-
    I went to see my PCP for a urinary tract infection today and she said there was a lot of stuff in my urine-ketones, blood (which is always there-which is why I also see a nephrologist), and some protein. She thinks the ketones are because of my high protein diet and she told me to try to eat a more balanced diet (more carbs, fruits, veggies). How is this possible with such a tiny pouch? Has this happened to anyone else and if so-what did you do? Is it dangerous to have ketones in your urine? I do worry about my kidney function. My nephrologist likes to do labwork (blood/urine) every 6 months to keep an eye on things. He doesn't think my labs have warranted doing a kidney biopsy at this point. The last time I saw the nephrologist was before my RNY. I just don't want my diet to be damaging to my kidneys.
    Has this happened to anyone--kidney damage as a result of the post-op diet? I know that it will be easier to eat a more balanced diet as a I get further out, right?
    Thank you all for your advice and help!
    Sincerely,
    Pam

  2. RainbowRN

    I know that when the atkins diet was really popular, more people started talking about ketones in the urine. The big deal about it is that protein molecules are actually really big and more difficult for the kidneys to filter. Therefore the kidneys can be damaged overtime. Now, I'm not sure about how long it takes or how much protein it would take to do that. All I know is that, last year before I even considered WLS, my NUT put me on a protein sparing modified fast. It was a diet that was primarily protein only. It was very high amounts of protein. Greater than 140mg a day. I was told that I would do the diet for 3 months and then I had to go off of it for 3 months and then back on for three months simply because of the risk of damage to my kidneys. I don't consume that much protein since surgery. I try to make sure I get in 60mg a day. I would be curious to find out if kidney damage is a possibilty for us. In all my research I have not heard of that being a side effect.

  3. bbearsmama

    Before I had my surgery, I did talk to my nephrologist about the high protein diet and he thought it would be fine. He said that 60 g. of protein is really not that much. What is considered the "normal" intake of protein (for people who haven't had wls)? I think it's around 50 g. of protein. I'm not sure, though. And the reality is-I struggle to get 60 g. in per day. Most days I don't even get there-it's more like 50 or 55 g.
    That is interesting about the protein molecules being big.
    Thank you so much for your reply!
    Pam :)

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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

Renal tubular acidosis (RTA) is acidosis and electrolyte disturbances due to impaired renal hydrogen ion excretion (type 1), impaired bicarbonate resorption (type 2), or abnormal aldosterone production or response (type 4). (Type 3 is extremely rare and is not discussed.) Patients may be asymptomatic, display symptoms and signs of electrolyte derangements, or progress to chronic kidney disease. Diagnosis is based on characteristic changes in urine pH and electrolytes in response to provocative testing. Treatment corrects pH and electrolyte imbalances using alkaline agents, electrolytes, and, rarely, drugs. RTA defines a class of disorders in which excretion of hydrogen ions or reabsorption of filtered bicarbonate is impaired, leading to a chronic metabolic acidosis with a normal anion gap. Hyperchloremia is usually present, and secondary derangements may involve other electrolytes, such as potassium (frequently) and calcium (rarelysee Table: Some Features of Different Types of Renal Tubular Acidosis* ). Chronic RTA is often associated with structural damage to renal tubules and may progress to chronic kidney disease . Some Features of Different Types of Renal Tubular Acidosis* Tre Continue reading >>

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Popular Questions

  1. kween1996

    Hello all,
    I’m a 5’4, 145 pound, 20 year old female, 27% body fat who works out (kickboxing) for about 1 to 1.5 hours a day. I’ve been on Dairy free Keto and doing 16:8 IF for about 3 weeks now and have gained 3 pounds. I was 142 when I started Keto. The macros I follow are 1207 calories, 90 g of Protein, 20 g of carbs and then usually around 80ish g of fat until I feel full. I meal prep ahead of time on Sundays so all my meals are planned and I don’t cheat. With lots of water, exercise, taking a multivitamin/B Complex/Green Tea Extract, dairy free (so no cheese or anything), or artificial sweeteners, I don’t know why I’m not losing any weight on Keto. I’ve seen this work for so many people and have been doing extensive research as to why it won’t work for me. I’ve tried recalculating my macros and gotten these 2 results:
    upping my calories to 1324 calories and 80 g of protein with 20 net carbs, 103 g of fat
    lowering my calories to 1177 and doing 103 g of protein, 20 net carbs and 73 g of fat.
    These two seem completely different macros and I don’t know which one to follow since what I do right now is in the middle of both.
    An example of lunch and dinner I have during IF are like 8 oz of ground turkey, 2 eggs and 1/2 an avocado for lunch and a tuna salad with spinach, flax seed, MCT oil and 1 egg for dinner. With TONS of water- I fill up my hydroflask (32 oz) around 5 times a day.
    I’m just saddened that I haven’t lost ANY weight on Keto when it seems to work for everyone else. I’ve gotten blood tests done as well and my hormones are fine. My goal weight is 120 so I do have a significant amount of pounds to go and would appreciate any advice from you! I have even stopped all nuts and nut butters because I read that those could be an impediment to weight loss. I’m considering doing an egg fast in a few days for 3 days to see if that brings about any change.
    If it helps, I never got the keto flu (maybe because I was around 40-50 g of carbs to begin with), I’ve been tested and found 0 hormonal or thyroid issues, I TRACK EVERYTHING, my ketostix say that I am in ketosis and don’t know what else to do at this point.
    Thank you so much for your time- your journey is SO incredibly inspiring and I would hope to some success on Keto. Open to ANY advice at all! Please help!

    My instagram ketokween1996 has a lot of my meals and their macros, calories and such! I made this to be more accountable of myself!

  2. Brad

    Mom’s Before And After Pics Prove The Scale Means Nothing
    She’s living proof that we need to worry less about the number on the scale and worry more about how our bodies move and function.

  3. Ijjunne

    I have some things that come to mind after reading your post.
    First, being in ketosis doesn’t mean being fat adapted. It takes time, 3 weeks is a short time. Your body needs to adapt to your new lifestyle. And I really mean lifestyle, you shouldn’t consider ketosis as a diet but a new way of life.
    Second, I think your protein intake is too high. You should eat 1 to 1,5 g of protein per kg of lean bodyweight. I don’t think that your lean mass is 90 kg . Decreasing your protein intake means increasing your fat intake.
    Third, you seem to be in the diet mentality like a lot of us women. You shouldn’t count calories. During your keto adaptation, your only concern should be to eat under 20g of carbs, moderate protein and fat to satiety.
    Finally, you should take your body measurements (chest, waist, hips, thighs and arms) to track your progress.

    I hope it helps. And keep calm and keto on.

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