Why Does Hyperchloremia Cause Metabolic Acidosis?

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Hyperchloremia Why And How - Sciencedirect

Volume 36, Issue 4 , JulyAugust 2016, Pages 347-353 Hyperchloremia Why and howHipercloremia: por qu y cmo Author links open overlay panel Glenn T.Nagami Open Access funded by Sociedad Espaola de Nefrologa Hyperchloremia is a common electrolyte disorder that is associated with a diverse group of clinical conditions. The kidney plays an important role in the regulation of chloride concentration through a variety of transporters that are present along the nephron. Nevertheless, hyperchloremia can occur when water losses exceed sodium and chloride losses, when the capacity to handle excessive chloride is overwhelmed, or when the serum bicarbonate is low with a concomitant rise in chloride as occurs with a normal anion gap metabolic acidosis or respiratory alkalosis. The varied nature of the underlying causes of the hyperchloremia will, to a large extent, determine how to treat this electrolyte disturbance. La hipercloremia es una alteracin electroltica frecuente que se asocia a una serie de distintos trastornos clnicos. El rin desempea una funcin importante en la regulacin de la concentracin de cloruro a travs de diversos transportadores que se encuentran a lo largo de la nefrona. Sin Continue reading >>

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  1. StaalesenArt

    Water fasting, no ketosis

    I'm on day 5 of water fasting, and I still feel hungry. And interestingly enough, I was LESS hungry the first couple of days, but today it seems my desire to eat and the uncomfortable feeling in my stomach has dialed up. I have ingested literally nothing but clean water and technically saliva, and yet I have no sense of ketosis at all.
    I can't prove I'm not in ketosis because I have no means to test my blood, nor will I spend the money to do so. I just know that no matter where I look, there's apparently real clear signs that you're in ketosis, and I have not reached that state apparently. Am I incapable of Ketosis? Is my body just refusing to run off of ketones? Is that possible?

  2. LMichaelM

    Forget bro science. All the published, established literature makes clear that within 24hrs of consuming no nutrients, perhaps a little longer for metabolic outliers, the human body's accessible glycogen reserves (stored sugar) become depleted; it then begins burning its stored fat for fuel, with the production of ketones as part of this biochemical process.
    This burning of stored fat and the associated ketone production in the stated condition of fasting is, by definition, ketosis.
    Whether it leaves you elated, dismayed or indifferent, after fasting for five days you, friend, must of necessity be in a state of ketosis. [Otherwise, you'd not be reading this, nor doing much of anything else either – you'd be dead.]
    Edit (elaboration on last paragraph): This is neither mere rhetoric nor exaggeration. For one example: anorexics of long duration whose accessible fat reserves are close to nil, should they enter a complete fasted state for even a day (taking no nutrients, neither via the GI tract nor intravenously) promptly begin metabolizing their bodies' protein stores (our third tier of energy substrates or potential fuel sources – after our stored sugar, then stored fat)…
    But wait. What are these "protein stores"? The body cannot "store" protein – all its protein is constitutional, structural constituents of its tissues, commonly its musculature, whether skeletal, smooth muscle, or cardiac muscle.
    Ah, that pesky cardiac muscle. The heart. Deprived of incoming nutrients (when fasting) their sugar stores (first-tier fuel substrate) depleted within a day, pathologically skinny anorexics lacking fat stores (our second-tier fuel substrate, burned by healthy individuals in ketosis) begin burning through their muscle, their constitutional muscle, not sparing their cardiac muscle. This is lethally weakened, and thus their death by heart failure ensues. A fate which, after fasting for five days, you escape only because you, presumably, possess ample fat… and you are in ketosis.
    tl;dr: You have been fasting for five days; your glycogen (sugar stores) were exhausted three or more days ago; and your heart is beating fine? Thank God for your fat stores, all that's keeping you alive! You're burning them up with an accompanying production of ketones (detectably or not), and this is ketosis. You. are. in. ketosis.

  3. LMichaelM

    Kind words, /u/infromsea… thank you. And generous, illustrative sharing of your personal experience.

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Whether due to bicarbonate loss or volume repletion with normal saline, the primary problems is in hyperchloremic metabolic acidosis hcl ammonium chloride loading, reabsorption proximal tubule reduced, part, because of hyperchloraemic acidosis, anion gap (in most cases). Administration of ns will decrease the plasma sid causing an acidosis this patient also had a normal anion gap hyperchloremic metabolic (hcma). Googleusercontent search. Normal anion gap (hyperchloremic) acidosis semantic scholar. Hyperchloremic metabolic acidosis is it clinically relevant? (pdf hyperchloremic in diabetes mellitus. Hyperchloremic acidosis wikipedia. Treatment of acute non anion gap metabolic acidosis ncbi nih. Aug 4, 2016 a normal ag acidosis is characterized by lowered bicarbonate concentration, which counterbalanced an equivalent increase in plasma chloride concentration. Acid base physiology 8. Hyperchloraemic metabolic acidosisdepartment of medicine. Mechanism of hyperchloremic metabolic acidosis. Hyperchloremic acidosis background, etiology, patient education emedicine. Respiratory acidosis alkalosis as with the hyperchloremic may result from chloride replacing lost bicarbonate. Although it ca

Hyperchloremic Acidosis

Normal human physiological pH is 7.35 to 7.45. A decrease in pH below this range is acidosis, an increase in this range is alkalosis. Hyperchloremic acidosis is a metabolic disease state disease state where acidosis (pH less than 7.35) with an ionic chloride increase develops.Understanding the physiological pH buffering process is important. The primary pH buffer system in the human body is the HCO3 (Bicarbonate)/CO2 (carbon dioxide) chemical equilibrium system. Where: HCO3 functions as an alkalotic substance.CO2 functions as an acidic substance. Therefore, increases in HCO3 or decreases in CO2 will make blood more alkalotic. The opposite is also true where decreases in HCO3 or an increase in CO2 will make blood more acidic. CO2 levels are physiologically regulated by the pulmonary system through respiration, whereas the HCO3 levels are regulated through the renal system with reabsorption rates. Therefore, hyperchloremic metabolic acidosis is a decrease in HCO3 levels in the blood. Anytime a metabolic acidosis is suspected, it is extremely useful to calculate the anion gap. This is defined as: Where Nais plasma sodium concentration, HCO3 is plasma bicarbonate concentration, and Cl Continue reading >>

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Popular Questions

  1. armaniqueen

    Hello everyone. I am having a bit of confusing on the mixed information I have found on getting my body to reach ketosis stage. Some say Mayo, sour cream and cheeses are allowed some say No! Which is it? Does anyone out there truly know the correct information to this. Also can anyone recommend a good whey protein w/out carbs or very little carbs? This is to be used in conjuction with the foods allowed for the ketosis stage. So far I have a pretty good idea of what is and isn't allowed but I'd like to know a little more.
    Also does anyone know the average weekly weight I can expect to lose once I am under this stage? My goal weight to lose is 20 lbs.
    Lookng forward to some great advice! Thanks!

  2. Maiden69

    From my experience. Mayo, Chesse, Suor Cream are good on Keto, ON MODERATION. You have to strive to keep the net amount of carbs lower than 30g a day if possible. Some people can go higher and stay in ketosis. I was eating 100g a day and I still had traces of ketones when tested with the stix. As far as whey protein, I'm taking UN Ultra Whey Pro. Very good taste, but any one with almost no carbs should do you good. Weight loss is also an individual thing. The first week you can lose quite a bit of weight, I lost 8 lbs. After that I think that 2 lbs a week is good weight loss, any more and you might be losing muscle, unless you have a big amount of fat to lose.

  3. AFTazz06

    Originally Posted by armaniqueen
    Hello everyone. I am having a bit of confusing on the mixed information I have found on getting my body to reach ketosis stage. Some say Mayo, sour cream and cheeses are allowed some say No! Which is it? Does anyone out there truly know the correct information to this. Also can anyone recommend a good whey protein w/out carbs or very little carbs? This is to be used in conjuction with the foods allowed for the ketosis stage. So far I have a pretty good idea of what is and isn't allowed but I'd like to know a little more.
    Also does anyone know the average weekly weight I can expect to lose once I am under this stage? My goal weight to lose is 20 lbs.
    Lookng forward to some great advice! Thanks! I believe Mayo, sour cream and cheeses are ok on keto ONLY on your cheat meals. As far as the actual diet is concerned, those things all contain empty carbs and they will kick you out of ketosis. So i say yes they're ok, but only on your cheat meals. As far as how much weight you'll loose, the average lbs you'll loose (assuming your doing everything correctly) is about 1-3lbs a week. When i did it there were a few of the first couple of weeks i would loose 5lbs but i'm pretty sure it was probably water weight. I used to weigh myself about every 2 weeks, no need to depend on the scale, i prefer the mirror cause it wont lie to you. Also on the protein, you can send me a PM and i'll let you in on which is best.

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Block 2, Week 8, Faculty Objective 6

Physiological Effects Of Hyperchloraemia And Acidosis

Physiological effects of hyperchloraemia and acidosis Chelsea and Westminster NHS Foundation Trust Chelsea and Westminster NHS Foundation Trust BJA: British Journal of Anaesthesia, Volume 101, Issue 2, 1 August 2008, Pages 141150, J. M. Handy, N. Soni; Physiological effects of hyperchloraemia and acidosis, BJA: British Journal of Anaesthesia, Volume 101, Issue 2, 1 August 2008, Pages 141150, The advent of balanced solutions for i.v. fluid resuscitation and replacement is imminent and will affect any specialty involved in fluid management. Part of the background to their introduction has focused on the non-physiological nature of normal saline solution and the developing science about the potential problems of hyperchloraemic acidosis. This review assesses the physiological significance of hyperchloraemic acidosis and of acidosis in general. It aims to differentiate the effects of the causes of acidosis from the physiological consequences of acidosis. It is intended to provide an assessment of the importance of hyperchloraemic acidosis and thereby the likely benefits of balanced solutions. Hyperchloraemic acidosis is increasingly recognized as a clinical entity, a new enemy within, Continue reading >>

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Popular Questions

  1. Throid

    Anyone got any info on this? My hair loss has got worse, it began when I stopped thyroid meds but hasn't improved. I've been taking DHEA all year as I am very low in this - but could it be causing more problems for me?

  2. JoanofArc

    Hi Throid,
    I haven't got any links for you but to answer your question,yes,I think DHEA could be contributing to your hair loss.Can I ask if you are getting it precribed?
    I too was very low in DHEA and was prescribed it a few years back by Dr Hertoghe in Brussels.I was only taking 15 mg as I am so sensitive to everything.Within two days my hair started to shed incessantly and never stopped whilst I was taking the stuff. I tried the non prescription 7-Keto DHEA and that was exactly the same result so I stop taking it.
    I think it does mention in the literature that it can cause hair loss,acne,and greasy skin if taken in too high a dose.Have you tried cutting your dose? Do you feel better in other ways whilst taking it?
    Can I ask why you stopped your thyroid medication? Perhaps that is contributing to the problem too.

    Regards Joan

  3. Throid

    Hi Joan
    Thanks for getting back to me.
    I started the DHEA because I've been so low in it for years, my endo wouldn't prescribe it so I buy the sublingual Douglas labs but only take 10mcgs a day. I had hair loss prior to it but am now very concerned it is making it worse. I just don't know what to do as I feel a bit better on it and it is helping me to get off HRT. I thought about switching to the 7-Keto too but from what you say this is not an option.
    My GP has agreed to do tests on all my sex hormones to see if we can work out what is going on. I am hoping it will happen but have had experience of the labs refusing to do the tests before so have fingers crossed as it is so expensive to have these tests done privately.
    I am back on thyroxine this year, I persuaded my endo to prescribe T3 and followed the Wilsons protocol. This was a disaster as the T3 made me feel very ill, me endo has always been unhelpful regarding my thyroid and said she doesn't think it is causing my problems. Because I got so ill on the T3 I decided to follow this up and tried to give it up, not wise and not something I will do again.
    Did your hair get better when you stopped the DHEA? I am going to try cutting it down to 5mcgs a day, am very worried as I have been trying to get off HRT for years and been unable to due to the hot flushes, I believe the DHEA is helping significantly with this. The hair started shedding agin when thyroxine stopped, but it is still going on so I'm very, very worried to say the least.


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