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Role Of Kidneys In Metabolic Acidosis

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

Renal Function During Metabolic Acidosis

Department of Animal Physiology and Cytobiology, Faculty of Biotechnology and Animal Husbandry, West Pomeranian University of Technology, Szczecin, Poland Metabolic acidosis influences renal structural and functional changes that occur to restore acid-base homeostasis. In this review selected aspects of these changes are discussed, focusing especially on alternations in tubular reabsorption and excretion, changes in water homeostasis and induction of hypertrophy. Also highlighted is the usage of proteomic techniques and gene expression analysis as useful tools which facilitate the obtaining of a wider view on changes in the kidneys during metabolic acidosis. MSc. in Biology, Department of AnimalPhysiology and Cytobiology, Faculty of Biotechnology and Animal Husbandry,West Pomeranian University of Technology, Doktora Judyma 6, 71-466 Szczecin,Poland. Barthwal MS: Analysis of arterial blood gases a comprehensive approach. J Assoc Physicians India 2004, 52, 573-577. Koeppen BM: Renal regulation of acid-base balance. Advan Physiol Educ 1998, 275, 132-141. Rutkowiak B: Zaburzenia trawienne i metaboliczne w stadach krow mlecznych. PWRiL, Warsaw 1987. Cheval L, Morla L, Elalouf JM, Douce Continue reading >>

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  1. keto_does_it_4_me

    hey guys! Ok, I've been almost a year on this boat, and so far, so good, keto makes me happy (check out my flair).
    The reminder: I got kidney stones over the week-end. ouch. They say it's the worst pain a human can endure, on par with some/most births. I love you more mom!
    I have never been a heavy water drinker, all my life. I raised it a bit on keto, but not enough. I would reach 2 liters (64 oz) about half the days, 25% between 1 and 2 liters, 25% less than a liter. Not good, I know. Results: 3-4 stones of 2-4 mm diameter. So, following an ambulance ride and a leg paralysis, the docs took care of this, let's be thankful, learn form it and move on.
    I also recently discovered I was low on electrolytes, as I was feeling very weak when doing high intensity exercise. I discovered (on /r/keto, of course) that adding a bit of potassium salt (no salt "salt") and sodium (regular table salt), would bring back my stamina, and it did!
    I did some more reaserch around here and found those to be interesting: ref 1, ref 2, ref 3, ref 4, ref 5
    And as per Lyle McDonald:
    Sodium: 3-5 grams in addition to the sodium which occurs in food
    Potassium: 1 gram in addition to the 1-1.5 grams of potassium which occur in food
    Magnesium: 300 mg "The Ketogenic Diet", page 79.
    And as per /u/yaterspen:
    With healthy kidneys, a daily potassium supplement of up to 1500mg to 3000mg is probably safe, but may irritate your GI lining. Try subdividing it into smaller doses (500mg has been suggested) spread throughout the day taken after food and with a lot of water to reduce irritation. Make sure you're getting enough magnesium, which helps your body absorb potassium.
    In those references, we also learn that excess sodium increases calcium excretion, which is conducive to stones. As well, we learn that potassium and sodium metabolisms are linked, as well as potassium and magnesium. And that drinking a lot of water flushes electrolytes, prevents stones formation, and that eating alkaline food dissolves calcium stones.
    I'll make sure to follow those recommendations...
    tl;dr 1-Don't drink enough, risk of kidney stones. 2- Wow, the human body is really a fine tuned machine!
    And finally, any of you care to share your experience with balancing your electrolytes? Thanks in advance!
    edit: kind reminder from /u/darthluiggi: RTFM ( FAQ)

  2. oryantge

    *Goes to get a huge glass of water...

  3. Shootermcgv

    Yep... Kidney stones are one of my biggest fears I think most guys can relate when you think about it.

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Access the mini course here: http://defeatkidneydisease.com/FreeMi... Hi, my name is David. A friend of mine was diagnosed with Stage 3 Chronic Kidney Disease (CKD) recently. He was shocked - he had not felt that bad and was there for a routine check-up. He was told that there were 5 CKD stages and that all he could do is try and slow the descent down to Stage 5 - Kidney failure. I am guessing if you are watching this video then you or a loved one has had a similar experience. My personal experience with Western medicine is that it can be very useful, life saving for many. But it can take a rather narrow view to what is possible. So for my friends sake, I went out to find the truth for myself. I learned about the CKD stages which I tell you about in the video. But in the course of my searches I came across Duncan, a second generation naturopath who was leading the world in the natural healing of kidneys. He has many patients who have reversed their Kidney disease, moving from Stage 3 to Stage 2 as an example. Knowing how severe the lower CKD stages are I asked Duncan if he would put together a course I could provide people like you and me who are looking to heal kidney disease. He

Current Status Of Bicarbonate In Ckd

Division of Nephrology and Hypertension, Case Western Reserve University, University Hospital Case Medical Center, Cleveland, Ohio Dr. Thomas H. Hostetter, Division of Nephrology and Hypertension, Case Western Reserve University, University Hospital Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106. Email: Thomas.Hostetter{at}uhhospitals.org Metabolic acidosis was one of the earliest complications to be recognized and explained pathologically in patients with CKD. Despite the accumulated evidence of deleterious effects of acidosis, treatment of acidosis has been tested very little, especially with respect to standard clinical outcomes. On the basis of fundamental research and small alkali supplementation trials, correcting metabolic acidosis has a strikingly broad array of potential benefits. This review summarizes the published evidence on the association between serum bicarbonate and clinical outcomes. We discuss the role of alkali supplementation in CKD as it relates to retarding kidney disease progression, improving metabolic and musculoskeletal complications. Patients with CKD experience a multitude of abnormalities and disabilities, among which metabolic acidosis Continue reading >>

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Popular Questions

  1. Marsh

    Potassium vs Low Carb Diet - A Balancing Act

    I have been wanting to ask a question for a long time.
    I have been trying to slowly get off my medicine, Metoprolol. My regular cardiologist is okay with me doing this, even suggesting it since I try to eat healthy. I have tried in the past unsuccessfully because I have experienced some extra heart beats. This time it seems to be working because I am making sure that I take approximately 800 mg of magnesium, and get at least 4700 mg of potassium from the foods I eat (I have been recording my foods using cronometer.com). At this point, I am only taking 12.5 mg of Metoprolol hoping to make it zero shortly.
    However, I find it difficult in trying to get 4700 mg potassium without supplementation and still maintaining a low carb diet which I am also trying to do. Some people on this forum follow a keto diet which states one should keep their carbs below 40g. But this seems difficult when needing so much potassium for a calm heart.. Those foods high in potassium are also high in carbs such as winter squash, potatoes (which I don't eat), tomato juice, etc. Beet greens seem to be low in carbs and high in potassium. So, I eat a lot of those as well as swiss chard. If I eat too many carbs, my sugar goes higher than I want it to be. Right now my fasting glucose is in the 80's or low 90's.
    I read again Hans Larsen's book, Lone Atrial Fibrillation Towards a Cure and he says we should adhere to a diet containing 30%protein, 30% fat, and 40% carbs. Isn't this too many carbs? I usually average around 15% protein, 67% fat, and 18% carbs. A keto diet would say I am eating too many carbs.
    I guess I am trying to find the right percentage for proteins, fat, and carbs and making sure I get enough fat for my brain. There is a lot of information out there that says we need saturate fat for our brain. But, it may depend on the individual since we are all an experiment of one
    My question - how does one maintain a low carb diet, keep a proper glucose level, and get at least 4700mg of potassium (without taking potassium supplements since Hans says he wouldn't take them) to make sure the heart stays in normal rhythm? Any thoughts would be most appreciated. Thanks!
    Marsh
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  2. GeorgeN

    Re: Potassium vs Low Carb Diet - A Balancing Act

    Marsh,
    I generally run my diet keto. Keeping track of my macros, at least in detail, is not my forte'. I once looked at it at 50g/day are fiber. Most of my carbs are from non-starchy veggies (I don't eat grains, legumes, nightshades or seeded veggies. My protein was 60 g, of which a max is 20g/day from shell fish, white fish or eggs (about a 4 oz serving). Most of my calories are from fat, mostly unfiltered olive oil, avocados and tree nuts (macadamia, pistachio, walnut, pecan, hazelnut). Also I don't track my potassium. I used to supplement with 2 or more g/day of potassium (unlike Hans, I have no issue with potassium supplements). I've found that I don't need to as long as I keep my magnesium intake (from supplements) high. Currently I take about 200 mg/day of potassium as supplements, as citrate. This is mostly for the citrate, as I had kidney stones 15+ years ago and the citrate mitigates that risk.
    As to how many carbs will be ketogenic. This will vary by individual. Exercise levels, metabolism and fasting will impact this quantity. I fast 22 hours/day.
    My last serum K was 4.3 mmol/L. This is right where I want it. So I have no reason to supplement. For me, magnesium is the key.
    I should note that a keto diet can pose risks for afibbers, especially during adaptation. The electrolyte shifts that occur with low insulin can cause afib in those who are at risk. A low carb and especially a keto diet is NOT a low sodium diet.
    George
    Edited 1 time(s). Last edit at 10/02/2016 10:44PM by GeorgeN.
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  3. Jackie

    Re: Potassium vs Low Carb Diet - A Balancing Act

    Hi Marsh - Most practitioners of functional and restorative medicine feel that dietary intake emphasis needs to be on more protein and more healthy fat and much less carb intake, so your ratios tend to meet some of the typical recommendations. Metabolic profile testing can determine areas of deficiency or excess, and as George indicates, genetic testing also dictates diet to help prevent genetic expression of gene mutations.
    About potassium… as George points out… we know that unless the body is optimized in intracellular magnesium, then adding more potassium typically doesn’t work and won’t help prevent arrhythmia.
    When discussing potassium intake, keep in mind that it is the ratio of potassium to sodium that makes the difference between health and imbalance disorders. If sodium intake overpowers potassium, then that prevents potassium from working as it should and among the consequences can be arrhythmia and hypertension and more.
    The RDA lists potassium intake as 4700 mg as a guideline. Many people find the use of the Cardymeter for measuring potassium levels helpful so they aren’t likely to go beyond a safe intake level from all sources. That said, however, Paleo man consumed between 10,000 and 11,000 mg of potassium-- obviously from natural sources.
    If you consider as an example…that the RDA for magnesium is 420 mg for men and 320 mg for women over age 51 years (source: National Institutes of Health Guidelines) … that serves to emphasize the “guideline numbers” point which, in the case of magnesium. is found to be woefully low when considering the actual uses throughout the body. If it were more realistic, then quite likely the increasing incidence and prevalence of Afib would not be as persistent. Many doctors conversant with magnesium’s function in the body make that observation.
    So, when potassium intake is solely from foods and with smaller appetites, it may be necessary to supplement to meet the 4700 mg range, just as it is with magnesium's effective range for afibbers. I know that I’m not alone in finding that I need to supplement with potassium because my appetite has diminished with age and my meal portions are small. I also supplement when I occasionally consume restaurant food as that can have high sodium content. (I use both potassium gluconate powder and potassium citrate) When we talk about potassium intake, the conversation must always consider as well, sodium intake from all sources – many of which are hidden or obscure.
    Note that there are various guidelines or ranges, including RDA, RDI, AIs or Adequate Intakes-- all used as goals for approximate intake. Obviously, there will be individual “need” or requirement variations according to age, gender, size, activity…and as we know, interferences that prevent or compete either in absorption/assimilation or utilization--such as an overabundance of Ca blocks Mg function as does sodium blocking potassium.
    Caveat: It’s obviously wise to understand the cautions for both magnesium and potassium supplementation which indicate that when used, it’s crucial to know for certain that one has healthy kidney function because excess potassium in individuals with chronic renal insufficiency (kidney disease) or diabetes can result in hyperkalemia or sudden death. Magnesium can also cause a problem but typically, before it becomes crucial, excess magnesium is eliminated rapidly via the bowel tolerance issue. However, in those with kidney dysfunction, supplementation with either should be medically supervised.
    Now, all that said…. back to Paleo man’s consumption of potassium.
    Lead author of The Salt Solution, Richard Moore, MD, PhD… says:
    Moore: “ Let me give you a very interesting statistic. In 1985, The New England Journal of Medicine published an article titled "Paleolithic Nutrition." The authors, who had credentials as anthropologists specializing in the Paleolithic era, determined that, on average, our caveman forebears got around 11,000 mg of potassium daily and about 700 mg of sodium. This, by the way, is about the same ratio that modern-day hunter / gatherers have. It works out to a dietary K Factor of 15.7.
    Today, in the United States, that 11,000 mg has shrunk to 2,500 mg of potassium. Meanwhile, the sodium intake has increased from 700 mg to 4,000 mg. This is a K Factor of 0.6. You would not expect that any animal species, human or otherwise, could live for several million years with a huge potassium intake and rather modest amounts of sodium and then suddenly flip-flop this ratio with impunity. The scientific literature supports our conclusions.
    There is absolutely no doubt that the imbalance thereby produced influences at least ten serious diseases and very probably several others. This is why we think The Salt Solution is an extremely important book, and we hope that people will read it. It will enable them to correct this huge dietary error. A daily ration of 2,500 mg of potassium is far too little. And, of course, as virtually everyone should know, 4,000 mg of sodium is at least ten times as much sodium as people need. [www.drpasswater.com]
    Dr. Moore has a PhD in Ph.D. in biophysics and a 40 year career as a college professor and research scientist. In addition to The Salt Solution, note these other books by Richard D. Moore, MD, PhD.. [www.amazon.com]
    Paleolithic diets had about 16 times more potassium than sodium, whereas modern "civilized" diets have about 1.6 times more sodium than potassium. Interview with Herb Boynton ( co-author The Salt Solution) on Potassium: [www.drpasswater.com]
    In 2011, Conference Room Session #72 on the topic of Potassium/Sodium Ratio in Atrial Fibrillation was published. It is worth restating the first few paragraphs here for relevant understanding and emphasis:
    February 7, 2011 – June 11, 2011
    SUBJECT:
    Potassium/Sodium Ratio in Atrial Fibrillation
    Sodium and potassium Biophysicist Richard D. Moore explains:
    "For purely physical reasons (connected with the law of osmotic e
    quilibrium), inside the cell the sum of sodium and potassium must
    be constant. This means that... sodium and potassium are unalterably
    linked together like two children on a teeter totter. You can’t change one
    without changing the other.
    "Thus, in the perspective of biophysics, it makes no sense to
    talk about either sodium or potassium alone - these two
    substances always affect each other in a reciprocal relation. Hence their
    ratio ... reflects the state of the living cell more completely than either
    sodium or potassium alone... It is not only a simplifying concept, but a much more scientifically
    valid measure of the state of health of the living cell.
    "Reflecting the action in the cell, potassium and sodium always work in a
    reciprocal manner in the whole body... This means that increased consumption
    of potassium will drive sodium out of the body through the kidneys. Thus,
    potassium has been called "nature’s diuretic"... This is an example of the fact
    that elevation of sodium inside our body cells must always be accompanied by
    a decrease in the potassium level." [1, 11]
    From the article Paleolithic Nutrition Revisited: A twelve-year
    retrospective on its nature and implications: [2]
    "The nutritional needs of today's humans arose through a
    multimillion year evolutionary process during nearly all of
    which genetic change reflected the life circumstances of
    our ancestral species. But, since the appearance of
    agriculture 10,000 years ago and especially since the
    Industrial Revolution, genetic adaptation has been unable to
    keep pace with cultural progress. Natural selection has
    produced only minor alterations during the past 10,000 years,
    so we remain nearly identical to our late Paleolithic ancestors and,
    accordingly, their nutritional pattern has continuing relevance.
    The pre-agricultural diet might be considered a possible paradigm
    or standard for contemporary human nutrition."
    Sodium (Na) and potassium (K) are critical nutrients, but today’s typical diet
    might supply 5 times the amount of Na, and only 1/4th the amount of K
    that we evolved with. In our evolutionary past the kidneys became configured to
    optimize the body's cellular Na and K levels by conserving the sodium available
    and by discarding excessive potassium. Our kidneys have essentially not changed
    since then, but the typical diet is now upside down, with disease-causing consequences
    for all cells and systems.
    Continue: [www.afibbers.org]
    Book review of The Salt Solution: [www.afibbers.org]
    Also: [www.amazon.com]
    NIH reference for Mg RDA [ods.od.nih.gov]
    Jackie
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Year 12 HSC Biology Active and Passive Transport in the Kidney! Hope it helps, leave comments for questions or simply subscribe or give me some feedback to improve my videos. All appreciation is appreciated :) Cheers, A document to look into for the kidneys is: http:--prelimbio.wikispaces.com-file-detail-16.1.1+The+Kidneys.pptx This document does wonders and is by David Fellows, a HSC teacher.

Role Of The Kidneys In Maintaining Normal Blood Ph

Role of the kidneys in maintaining normal blood pH Summarized from Hamm L, Nakhoul N, Hering-Smith K. Acid-base homeostasis. Clin J Amer Soc Nephrology 2015; 10: 2232-42 The maintenance of blood pH within normal limits (7.35-7.45), called acid-base homeostasis, is a complex synergy involving three organs (lungs, kidneys and brain) as well as chemical buffers in blood and blood cells (erythrocytes). This vital physiologic process is the subject of a recent expert review article, authored by three academic/research nephrologists that focuses principally, although not exclusively, on the role of the kidney. The article begins with a broad overview of acid-base homeostasis, its pathophysiological importance and some familiar basic concepts such as bicarbonate buffering system and the related Henderson- Hasselbalch equation. The concept of metabolic/respiratory components of acid-base balance allows brief discussion of the integrated role of brain, lungs and kidneys. This introduction paves the way for the central focus of the article, which is the authors research interest: the role of the kidneys in acid-base homeostasis. In broad terms this role has two aspects that both relate to m Continue reading >>

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Popular Questions

  1. abuvia

    When I decided to start dieting (about a month ago) I didn't know about NK. I just started doing the same old, same old... tracking foods in m.f.p. and counting calories. I used the automatic tools on m.f.p. at that time to determine my calorie goal.
    After 2 weeks diligently weighing food and counting calories I'd lost NOTHING and a friend suggested going low-carb. So, I did. And after discovering this site I've begun watching my protein and eating more fat. However, this is all I've adjusted.
    Tonight I finally calculated my macros using the info in the "Just the Facts, Ma'am" post. I was happy to see that they (percentage-wise) closely matched my actual calorie breakdown over the past two weeks. EXCEPT for one big difference: I've been aiming for 1,200 calories/day (as recommended by m.f.p.) and tonight's calculation indicates I should have a 1,761 calorie goal.
    I am reading more and more about NK and am slowly making the paradigm shift... but, it's still hard for me to believe that I could lose weight as a 5' 4", 165 lb woman by eating that many calories!
    Thoughts?
    I certainly don't want to risk any loss of my lean body mass. But, I'd really like to hear from anyone who's had success losing weight on significantly more calories/day than would be allowed on a traditional calorie-restricted diet.
    A little perspective on my situation: On 1,200 calories/day combined with eating NK-style I've had great results compared to past diets. I'm down about 6 lbs. Though, of course, much of that is the initial water weight Also, I am rarely hungry and often have to make a real effort fill that calorie allotment each day.

  2. EricaHV

    1600 calories is considered a "starvation diet" no matter what diet you are on, but in ketosis you are actually getting nutrition from your own body.
    I have under-eaten and gained weight, so under-eating was a concern when I started this. I am not going to give you a definate answer, I am newer, but I am finding my hunger varies and I tend to want to eat between 1200 and 1800 calories, depending on my activity ( I had a 6.5 hour workout today training for a tournament so I may try to force myself to eat a little more) I am eating more than before and losing weight.
    Keto is a natural appetite suppressant, and fortunately when you are not eating the calories your body is supplementing them. I am in super fear of under- eating again, so the days I end up with 800 or 900 calories (it has happened a few times) I get in another meal. I am not sure if it is smart or not.

  3. lovetoknit

    Quote:

    Originally Posted by abuvia
    When I decided to start dieting (about a month ago) I didn't know about NK. I just started doing the same old, same old... tracking foods in m.f.p. and counting calories. I used the automatic tools on m.f.p. at that time to determine my calorie goal.
    After 2 weeks diligently weighing food and counting calories I'd lost NOTHING and a friend suggested going low-carb. So, I did. And after discovering this site I've begun watching my protein and eating more fat. However, this is all I've adjusted.
    Tonight I finally calculated my macros using the info in the "Just the Facts, Ma'am" post. I was happy to see that they (percentage-wise) closely matched my actual calorie breakdown over the past two weeks. EXCEPT for one big difference: I've been aiming for 1,200 calories/day (as recommended by m.f.p.) and tonight's calculation indicates I should have a 1,761 calorie goal.
    I am reading more and more about NK and am slowly making the paradigm shift... but, it's still hard for me to believe that I could lose weight as a 5' 4", 165 lb woman by eating that many calories!
    Thoughts?
    I certainly don't want to risk any loss of my lean body mass. But, I'd really like to hear from anyone who's had success losing weight on significantly more calories/day than would be allowed on a traditional calorie-restricted diet.
    A little perspective on my situation: On 1,200 calories/day combined with eating NK-style I've had great results compared to past diets. I'm down about 6 lbs. Though, of course, much of that is the initial water weight Also, I am rarely hungry and often have to make a real effort fill that calorie allotment each day. If you do not need all those calories, don't eat them. If you are not hungry, don't eat. If you were lower in calories than you are now, I would just add some fat to my meals to up the calories. As long as you eat at least 1200 calories, you should be fine.
    Carolyn

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