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Why Does Potassium Shift In Acidosis?

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Renal Tubular Acidosis & Potassium Disorders 10-3

Understand the role of the proximal tubule in bicarbonate reabsorption. The majority of bicarbonate reclamation occurs in the proximal tubule through the Na+/H+ exchanger Understand how the kidneys excrete hydrogen ions through ammoniagenesis. Active transporters in the distal tubule secrete hydrogen ion against a concentration gradient. Also, NH3 is generated in the proximal tubule by the deamidation of glutamine to glutamate, which is subsequently deaminated to yield NH3 and -ketoglutarate. The enzymes responsible for these reactions are up-regulated by acidosis and hypokalemia. NH3 builds up in the renal interstitium and passively diffuses into the tubule lumen along the length of the collecting duct, where it is trapped by H+ and excreted as NH4. Understand the clinical utility of urine anion gap. It is an estimate of NH4+ excretion, which accounts for the majority of acid excretion. -if Cl- is the anion balancing the charge of NH4+, the gap is negative b/c the chloride is greater than the sum of Na+ & K+ (which are also large components of urine) Understand the collecting tubule mechanism and stimuli for hydrogen ion and potassium secretion. Aldosterone directly increases the Continue reading >>

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  1. Alexander Joo

    From the Keto Master himself, Lyle McDonald (who actually despises being called Keto Master):
    Cyclical Ketogenic Diets and Endurance Performance
    Basically, keto diets probably don't improve endurance, but don't hurt it. But a cyclical keto diet (carb-loading) will improve protein synthesis.

  2. Xavi Vives

    I recently ran 50k. Not only on ketosis but after almost four days of fasting.
    I've been in induced ketosis for 90% of the time in the last couple of years. I've been amazed with the metabolic changes my body has undergone.
    Being a runner, I started questioning this myself. Few weeks ago I finally attempted running a marathon on ketosis with the single purpose of answering this question.
    I've made a video and write my thoughts on this post:
    Running 50km after 82h of fasting. My conclusions.
    Not only its possible but from my point of view has enormous advantages.
    I didn't feel hunger at all. Not during the race. Not after.
    The only pain/injury I suffer was muscular fatigue, soreness on my feet, and few small cramps (probably due to dehydration).
    It completely removes any concern related to food.
    Taking care of the previous meals
    Bringing gels and consuming them at the right time.
    No stomach aches

    No need to go to bathroom.

    My weight was 4Kg less by the time I started running.
    That said. I'm not a racer. It wasn't my intention to go fast.
    Maybe with in a glycolysis state I would have performed better.
    Although for the last months I've always run on ketosis and most of the time with few hours of fasting, this is the only experiment I've done with these extreme circumstances, to generalize anything about it would be a bad idea.
    My main takeaway is that its completely doable it simplifies the experience and concerns and reduces the potential causes for failure.

    I'm planning more related experiments, and I would love to hear about any experience or input anyone can have. Let me know .

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What is ALKALOSIS? What does ALKALOSIS mean? ALKALOSIS meaning - ALKALOSIS pronunciation - ALKALOSIS definition - ALKALOSIS explanation - How to pronounce ALKALOSIS? Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Alkalosis is the result of a process reducing hydrogen ion concentration of arterial blood plasma (alkalemia). In contrast to acidemia (serum pH 7.35 or lower), alkalemia occurs when the serum pH is higher than normal (7.45 or higher). Alkalosis is usually divided into the categories of respiratory alkalosis and metabolic alkalosis or a combined respiratory/metabolic alkalosis. Respiratory alkalosis is caused by hyperventilation, resulting in a loss of carbon dioxide. Compensatory mechanisms for this would include increased dissociation of the carbonic acid buffering intermediate into hydrogen ions, and the related excretion of bicarbonate, both of which lower blood pH. Hyperventilation-induced alkalosis can be seen in several deadly central nervous system diseases such as strokes or Rett syndrome. Metabolic alkalosis can be caused by rep

Acute/chronic Acidosis/alkalosis And Potassium Excretion

SDN members see fewer ads and full resolution images. Join our non-profit community! Acute/Chronic Acidosis/Alkalosis and Potassium excretion This is my first post on sdn. I am hoping someone will be able to help me out with this. While watching Dr Kudrath's physio lecture on Renal physio, I was not entirely able to understand the differences in Potassium excretion in the cases of acute and chronic acidosis, and acute and chronic alkalosis. So far, this is the explanation I came up with. In acute acidosis, we get hyperkalemia --> increased Potassium filtration --> increased Potassium in cortical collecting duct --> less driving force for Potassium excretion-->less Potassium excretion. In chronic acidosis, we still have hyperkalemia, but due to decreased Sodium reabsorption in PCT (high H+ in PCT --> low Na+ reabsorption in PCT-->low water retention in PCT), we will get increased tubular flow in cortical collecting ducts. This will lead to cancellation of the effect of hyperkalemia on driving force, in fact increasing driving force for potassium excretion, and finally leading to increased potassium excretion. In chronic or acute alkalosis, we have less potassium in tubular fluid, w Continue reading >>

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  1. * DKA explanation

    * DKA explanation

    Below you will find a terrific explanation of DKA from one of the instructors at Med School Tutors. If you like what you see and may be interested in learning more about one-on-one instruction from MST, then please visit their website at www.medschooltutors.com
    In order to understand how to treat DKA, it is useful to first understand what is going on in the body when DKA develops. First of all, DKA (diabetic ketoacidosis) typically develops when a Type I diabetic does not take his or her insulin for a prolonged period of time. It may also be the presentation for new onset diabetes. Because these patients are insulin deficient, they are not able to take up glucose into their cells. This results in two important consequences: 1)glucose builds up in the blood and causes hyperglycemia and 2)the body's cells are forced to breakdown fat for energy, instead of glucose.
    These are very significant consequences... The hyperglycemia results in an osmotic diuresis, because the proximal tubule of the kidney can't reabsorb all the glucose filtered into the nephron. What is osmotic diuresis? Simply that the hyperglycemia (usually >300) causes the body to excrete lots and lots of water, because the osmotic pull of all the glucose particles prevents the reabsorbtion of water in the collecting duct. This means that patients with DKA are peeing their brains out!! They pee out sodium, potassium, and water.. And are therefore, very very very DEHYDRATED, sodium depleted, and potassium depleted.
    Now for the metabolism end of things... The body cells are forced to metabolize fat for energy rather than glucose. How do they accomplish this? - beta-oxidation of fatty acids. This results in excess production of ketone bodies which deplete available acid buffers. This causes a significant metabolic acidosis, with a high anion gap due to the presence of ketoacids. The acidosis causes potassium to shift from the intracellular space to the extracellular space. This may result in a normal or high serum potassium level. This normal or high potassium level masks what is typically significant potassium depletion because the person was peeing all their potassium out as a result of the uncontrolled hyperglycemia.
    So what are we going to do now? I will give a very brief answer for now, expect people to ask questions in the meantime, and then provide a more thorough approach to treatment in the coming days.
    1)Give the patient tons of normal saline. Why? - because your patient is dehydrated as all hell. They have been peeing out every last drop of water because of their severe uncontrolled hyperglycemia. These patients require liters of fluid to replenish all the fluid they've lost as a result of the osmotic diuresis.
    2)Give them insulin. Why? - NOT because it will lower the blood glucose level, but because it will cause a shift away from fat metabolism and toward glucose metabolism. This will slow the production of ketone bodies which are precipitating the metabolic acidosis. Thus, I will repeat, we give insulin to shift away from fat metabolism and stop the production of ketone bodies.
    3)Give the patient potassium. Why? - As we discussed earlier, the person has been peeing out all of their potassium stores and are overall very potassium depleted, despite having normal or high serum potassium levels to begin with. In addition to being potassium depleted, the insulin you are giving will cause a shift of potassium from the extracellular space to the intracellular space, which will drop the serum potassium. Thus, we give DKA patients potassium way before they become hypokalemic.
    4)Give the patient dextrose. Why? - They insulin you are giving the patient is obviously going to cause the serum glucose to decrease. We give glucose to prevent hypoglycemia as we continue to give insulin.
    How do we know when we are finished treating these patients? - When the anion gap returns to normal.
    That's all for now. Please ask any questions you have. I will be giving more specifics about DKA management in the near future.
    PS: Does anyone know the dangerous consequence of giving DKA patients fluid too rapidly? What are the symptoms this may cause, and what is the pathophysiology behind these symptoms?

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What is SHIFT WORK? What does SHIFT WORK mean? SHIFT WORK meaning - SHIFT WORK definition - SHIFT WORK explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Shift work is an employment practice designed to make use of, or provide service across, all 24 hours of the clock each day of the week (often abbreviated as 24/7). The practice typically sees the day divided into shifts, set periods of time during which different groups of workers perform their duties. The term "shift work" includes both long-term night shifts and work schedules in which employees change or rotate shifts. In medicine and epidemiology, shift work is considered a risk factor for some health problems in some individuals, as disruption to circadian rhythms may increase the probability of developing cardiovascular disease, cognitive impairment, diabetes, and obesity, among other conditions. Shift work can also contribute to strain in marital, family, and personal relationships. Shift work increases the risk for the development of many disorders. Shift work sleep disorder is

Why Does Acidosis Cause Potassium To Shift From Icf To Ecf ? : Medicalschool

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  1. formyhealth

    I get mouth sores when going into ketosis (and I guess being in ketosis, too). I have noticed that this happens and its been pretty consistent over the last decade. Today I got a new one and I think its because I didn't drink my normal amount of water (a gallon) yesterday. Does this happen to anyone else? Do you agree about the water?

  2. SweetSugaree

    Hi,
    I get mouth sores as well when I do not drink tons of water like I should. I will wake up in the morning with a sore due to dry mouth. What I have learned to do is keep water next to my bed, also, I make sure before i go to bed I drink a cup of water or so. One thing I also do is right before bed I swish with Biotene. It really does help a lot. Hope you can find some things that work for you.

  3. E.W.

    Are you talking about canker sores, those small real painful sores? If you are I
    found that if I went to bed with a milk of magnesia tablet on it by the time i got up
    in the morning it was almost gone. Sure it hurts for a moment when you first put
    it on the sore but this only last a few seconds. Then just put another one or 2 on the
    sore during the day and it's gone.

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