diabetestalk.net

What Is Metabolic Acidosis?

Share on facebook

Basic Interpretation Of Metabolic Acidosis

Basic Interpretation of Metabolic Acidosis Melissa Beaudet Jones is a pediatric critical care nurse practitioner in the cardiac intensive care unit at Childrens National Medical Center, Washington, DC. She recently completed the pediatric critical care nurse practitioner program at the University of Pennsylvania in Philadelphia Corresponding author: Melissa Beaudet Jones, Cardiac Intensive Care Unit, Childrens National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010 (e-mail: mejones{at}cnmc.org). Assessing the relationship between abnormal blood gas findings and a patients overall clinical condition is often challenging. Metabolic acidosis occurs in a variety of clinical contexts in pediatric intensive care units. Nurses must know the basic concepts of acid-base balance, the 2 types of metabolic acidosis (normal and elevated anion gap acidosis), and the common causes of each type of metabolic acidosis. This article has been designated for CE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives: Describe the significance of the anion gap in diagnosing metabolic acidosis in pediatric patients Dis Continue reading >>

Share on facebook

Popular Questions

  1. Alison

    I am a breast feeding mother, infant is 3 months and some change
    Any thoughts on going into ketosis while BF. I am sure it is not harmful. After all the human race
    Is still alive right?

  2. teach2183

    I think there's some info on kellymom about it. But really there's no reason to limit carbs while breastfeeding. You shouldn't be making any drastic changes or you risk your milk drying up.

  3. badgergirl

    I read - sorry, can't remember where - that diet actually plays little part in changing the comp of breast milk. I'd say you'll be fine.

  4. -> Continue reading
read more close
Share on facebook

Evaluation Of Metabolic Acidosis

The presence of metabolic acidosis is a clue to the possible existence of several underlying medical conditions. Arterial pH <7.35 defines acidosis. Metabolic acidosis is indicated by a decrease in the plasma bicarbonate level and/or a marked increase in the serum anion gap (AG). Metabolic acidosis may occur due to the following reasons: Addition of strong acid that is buffered by and consumes bicarbonate ion Loss of bicarbonate ion from the body fluids, usually through the GI tract or kidneys Rapid addition to the extracellular fluid of a nonbicarbonate solution. Differentiating between the causes of metabolic acidosis begins with calculation of serum AG. Serum AG is calculated by subtracting the sum of major measured anions, chloride (Cl) and bicarbonate (HCO3), from the major measured cation, sodium (Na+). Normal serum AG is due to the difference between unmeasured anions such as sulfate (SO4), phosphate (PO4), albumin, and organic anions, and unmeasured cations such as potassium (K+), magnesium (Mg+), and calcium (Ca2+). Plasma proteins also play a role in maintaining normal serum AG. [1] Dubin A, Menises MM, Masevicius FD, et al. Comparison of three different methods of evalu Continue reading >>

Share on facebook

Popular Questions

  1. Deranged_hypnotist

    Hey all, So I began this Keto diet over 1 month ago and the results have been FANTASTIC! I have lost 35 pounds! (M/6'1 Sw: 245 CW: 210 GW: 180) I have been extremely happy with myself now and its all thanks to you guys. Sadly though yesterday while checking my ketosticks i saw blood in my urine and after a 7 hour ER visit I was told by the doctor that I had passed a kidney stone and gotten a UTI from it as well. I have never had a kidney stone in my life or any major health problems (aside from being overweight). The doctor told me to get off my diet until I can see an urologist to find out why I have a kidney stone. The thing is the next available appointment is not for a long time since I work 2 jobs. So I have done a bit of research and a side effect of being in ketosis is kidney stones (from random online website).
    So my questions to r/keto is 1. How often does this happen? 2. Is this Research Valid Online? 3. Where do I go from here?
    I still want to continue keto for the next 30 more pounds.
    P.S. I do not want this post to discourage anyone from trying keto, EVERYONE'S body is different.

  2. gogge

    Higher protein intake increases the calcium absorption in the gut, and consequently increases the calcium excreted in the urine. Ketosis increases the need to balance blood pH as ketones are acidifying, one way the body likely does this i by increasing calcium leaching from the bones, this also increases urine calcium excretion.
    Increased calcium levels in the urine increases the risk of calcium-oxalate stone formation.
    Excretion of ketones in the urine increases urine acidity, as does the increased excretion of uric acid (can lead to supersaturation, the uric acid can't dissolve and form crystals).
    Increased urine acidity increases the risk of kidney stone formation, lower levels of citrate in the urine also increases the risk of stone formation.
    Paul over at perfecthealthdiet.com has an article on kidney stones and carb restriction, "Dangers of Zero-Carb Diets, IV: Kidney Stones".
    Generally the best way to counter this is to eat more vegetables, most have a negative potential renal acid load (PRAL), which means they'll reduce the acidity of urine (here's a list of foods and their PRAL score). Even calcium rich foods can help as the calcium will bind to oxalate (chelation) in the gut and prevent absoption.
    Increased water intake also helps as it balances the urine pH and prevents supersaturation (through dilution) as you pee more, in general dehydration is a common risk factor for stone formation.
    Another more drastic way to reduce calcium excretion, reduce urine acidity, and increase urine excretion of citrates, is to supplement with potassium citrate. It's been tested in epilepsy studies and resulted in a very high reduction in stone formation incidents (0.9% of patients compared to the 25% Paul mentions in his article):
    Successful empiric administration of Polycitra K at KD onset resulted in a kidney-stone incidence of 0.9% (1 of 106) compared with administration only because of hypercalciuria, 6.7% (13 of 195; P = .02).
    McNally MA, et al. "Empiric use of potassium citrate reduces kidney-stone incidence with the ketogenic diet." Pediatrics. 2009 Aug;124(2):e300-4. Epub 2009 Jul 13.
    You probably need to talk to your doctor about that as potassium is usually limited to ~99 mg for OTC tablets.
    Anecdotaly another thing sometimes used is sodium (or potassium) bicarbonate, as it also reduces urine acidity. I haven't seen any studies on it, but WebMD has some articles on it, "Sodium Bicarbonate (Baking Soda) for Kidney Stones". It's probably a good idea to discuss this with your doctor before starting taking any.

  3. [deleted]

    I had kidney stones about 3 years ago and from what I understand is that there are two different types. Calcium stones and uric acid stones.
    Calcium stones are more often than not a result of not enough fluid intake or an over abundance of calcium in your diet. Were talking multiple Tums a day, a wheel of cheese, gallons of cream - for most people. Others can just be an increase in calcium intake that the body is not used to. Such as going from little to no calcium intake, to hitting well over the suggested daily amount. This could very well be the case with you.
    From what I understand as well, uric acid stones are likely hereditary.
    At the end of the day, no, your keto diet is not the cause of your Kidney stones.
    Personally, I would never wish the pain of a kidney stone onto my worst enemy. So your best course of action is to be sure you're drinking plenty of water. Make sure your pee is always crystal clear. Increase your magnesium intake, either via supplements or more easily, eat an avocado every day. You also have to make sure you supplement your magnesium with calcium. This sounds counterintuitive to what I just stated, but the two work in conjunction with each other ( i dont know the exact science of it). I would suggest chewing on 1 or 2 Tums a day (depending on how much cheese and other dairy products you're already eating).
    Hope this helps!

  4. -> Continue reading
read more close
Share on facebook

Metabolic Acidosis - Endocrine And Metabolic Disorders - Merck Manuals Professional Edition

(Video) Overview of Acid-Base Maps and Compensatory Mechanisms By James L. Lewis, III, MD, Attending Physician, Brookwood Baptist Health and Saint Vincent’s Ascension Health, Birmingham Metabolic acidosis is primary reduction in bicarbonate (HCO3−), typically with compensatory reduction in carbon dioxide partial pressure (Pco2); pH may be markedly low or slightly subnormal. Metabolic acidoses are categorized as high or normal anion gap based on the presence or absence of unmeasured anions in serum. Causes include accumulation of ketones and lactic acid, renal failure, and drug or toxin ingestion (high anion gap) and GI or renal HCO3− loss (normal anion gap). Symptoms and signs in severe cases include nausea and vomiting, lethargy, and hyperpnea. Diagnosis is clinical and with ABG and serum electrolyte measurement. The cause is treated; IV sodium bicarbonate may be indicated when pH is very low. Metabolic acidosis is acid accumulation due to Increased acid production or acid ingestion Acidemia (arterial pH < 7.35) results when acid load overwhelms respiratory compensation. Causes are classified by their effect on the anion gap (see The Anion Gap and see Table: Causes of Metab Continue reading >>

Share on facebook

Popular Questions

  1. needtolose4me2

    since last week when I messed up and had some ad carbs one day, I basically started over Tuesday. I was really good all day Tuesday and Wednesday. Wednesday night I used a ketosis stick and it came up "trace". is that normal?should it take longer to get into ketosis? I was doing good the first 3 weeks (however not measuring my ketone levels) then all of a sudden I gained 2 pounds at which point I got aggrivated and screwed up for one day. the next day I got right back in the groove. I know my carbs are low, Ihaven't gotten on a scale,but this trace amount of keytones is concerning me. DO you think I should do some kind of fast (could onl really stomach the macadamia nut one) or wait it out a bit longer?
    thanks
    maggie

  2. JerseyGyrl

    I would not be too concerned about the Ketosis Stix....they have been known to not be accurate. If you are drinking a lot of water (as you should be) or eating a lot of fat & protein, they can give you false readings.
    Eating something you shouldn't, can definately knock you out of ketosis. Getting back into ketosis can vary depending on the person.
    As far as "fasts" are concerned, personally, I woudn't consider a fast unless I was in a very serious stall (not losing lbs OR inches). My best advice to you is to do a clean induction (only real foods..meat,eggs,cheese, veggies, etc) and be patient. Sometimes we get so anxious to lose the unwanted pounds we forget that we didn't gain them overnite & we aren't going to lose them overnite.
    All the best to you,
    Kim

  3. Tiffany_Bracelet

    For me, it depends on the amount of water and foods that I consume. Ketosis makes my mouth really dry....so I don't go into a deep ketosis like I have before with the meat/egg fast.

  4. -> Continue reading
read more close

No more pages to load

Related Articles

  • Respiratory Acidosis And Metabolic Acidosis At The Same Time

    Acute acid-base disorders. 2. Specific disturbances. Evaluation of the acid-base status of the body requires measurement of bicarbonate (total carbon dioxide) concentration, pH, and partial pressure of CO2 in arterial blood. Calculation of standard bicarbonate and base excess or deficit is not necessary. The normal concentration of free hydrogen ions (H+) is approximately 40 millimoles/liter, which is equivalent to a pH of 7.4. The normal load o ...

    ketosis Apr 29, 2018
  • Respiratory Acidosis Vs Metabolic Acidosis

    Don't miss your chance to win free admissions prep materials! Click here to see a list of raffles . In a question involving the determination between if a shift in PCO2 / HCO3- / pH, is it safe to say that if the PCO2 is what is changing first, then it is respiratory and metabolic is the compensatory mechanism? In respiratory, PCO2 is changing which then changes the HCO3-, so how do you tell between metabolic vs. respiratory if they don't tell y ...

    ketosis Apr 30, 2018
  • Which Metabolic Rate Resulted In Metabolic Acidosis?

    The kidneys and lungs maintain the balance (proper pH level) of chemicals called acids and bases in the body. Acidosis occurs when acid builds up or when bicarbonate (a base) is lost. Acidosis is classified as either respiratory or metabolic acidosis. Respiratory acidosis develops when there is too much carbon dioxide (an acid) in the body. This type of acidosis is usually caused when the body is unable to remove enough carbon dioxide through bre ...

    ketosis Jan 11, 2018
  • How Does Ketoacidosis Cause Metabolic Acidosis

    Diabetic ketoacidosis (DKA) is a serious metabolic disorder that can occur in animals with diabetes mellitus (DM).1,2 Veterinary technicians play an integral role in managing and treating patients with this life-threatening condition. In addition to recognizing the clinical signs of this disorder and evaluating the patient's response to therapy, technicians should understand how this disorder occurs. DM is caused by a relative or absolute lack of ...

    ketosis Jan 3, 2018
  • Metabolic Acidosis And Metabolic Alkalosis Ppt

    Acid-Base Disorders in Patients with Chronic Obstructive Pulmonary Disease: A Pathophysiological Review Department of Internal Medicine and Systemic Diseases, University of Catania, 95100 Catania, Italy Received 29 September 2011; Accepted 26 October 2011 Copyright 2012 Cosimo Marcello Bruno and Maria Valenti. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, ...

    ketosis Apr 29, 2018
  • Why Is Dka Metabolic Acidosis

    Diabetic ketoacidosis (DKA),the most common and serious acute complication of diabetes, is characterized by hyperglycemia and severe high–anion-gap metabolic acidosis with ketonemia (1). In DKA, the high anion gap is attributed largely to excessive production of blood ketone bodies, and serum β-hydroxybutyrate quantification is recommended for the diagnosis and monitoring of DKA (2). However, even counting of all the ketone bodies, including ...

    ketosis Mar 31, 2018

More in ketosis