High Anion Gap Metabolic Acidosis

Jun 20, 2017 by in NEPHROLOGY Comments Off on High Anion Gap Metabolic Acidosis

From the above reaction, excess lactate production can be expected by the following pathophysiologic processes: 1. Increased pyruvate production caused by intravenous (i.v.) glucose or epinephrine infusion, and metabolic or…

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Disorders of Potassium: Hyperkalemia

Jun 20, 2017 by in NEPHROLOGY Comments Off on Disorders of Potassium: Hyperkalemia

Cause Mechanism 1. Exogenous intake Oral Excess oral intake  High K+—containing foods (fruits, salt substitutes, KCl supplements, river bed clay, burnt match heads, raw coconut juice)   Herbal medications (horsetail, noni…

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Hyperchloremic Metabolic Acidosis: Nonrenal Causes

Jun 20, 2017 by in NEPHROLOGY Comments Off on Hyperchloremic Metabolic Acidosis: Nonrenal Causes

Intestinal Diarrhea Biliary fistula Pancreatic fistula Villous adenoma Gastrointestinal (GI)–ureteral connections Ureterosigmoidostomy Ureterojejunostomy Ureteroileostomy Drugs Laxatives Cholestyramine Before we discuss the pathophysiology of diarrhea, it is essential to understand water…

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Disorders of ECF Volume: Volume Contraction

Jun 20, 2017 by in NEPHROLOGY Comments Off on Disorders of ECF Volume: Volume Contraction

Extrarenal loss Renal loss Gastrointestinal losses Na + loss by the normal kidney Vomiting Diuretics Diarrhea Adrenal insufficiency Nasogastric suction Decreased renin production Fistulas Na + loss by the abnormal…

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Renal Handling of NaCl and Water

Jun 20, 2017 by in NEPHROLOGY Comments Off on Renal Handling of NaCl and Water

Fig. 3.1 Cellular model for Na+ entry into the first half (early part) of the proximal tubule. Note that many of these mechanisms are also present in the second half…

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Disorders of Magnesium: Physiology

Jun 20, 2017 by in NEPHROLOGY Comments Off on Disorders of Magnesium: Physiology

Fig. 23.1 Mg2+ homeostasis in an adult subject. (Filtered load of Mg2+ equals plasma free Mg2+ concentration of 1.1 mg/dL times GFR of 180 L/day; i.e., 180 L × 11 mg/L = 1,980 mg/day. Note that the intake of…

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Disorders of Phosphate: Hypophosphatemia

Jun 20, 2017 by in NEPHROLOGY Comments Off on Disorders of Phosphate: Hypophosphatemia

Cause Mechanism Shift from extracellular to intracellular compartment Glucose Transcellular distribution Insulin Transcellular distribution Catecholamines Transcellular distribution Hyperalimentation Glucose-induced cellular uptake Respiratory alkalosis Transcellular distribution Refeeding syndrome Glucose and insulin-induced…

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Disorders of Calcium: Physiology

Jun 20, 2017 by in NEPHROLOGY Comments Off on Disorders of Calcium: Physiology

Form mg/dL Percentage of total Total 10 100 Ionized 5 50 Protein-bound 4 40 Complexed 1 10 Ca2+ plays a significant role in cellular metabolic functions; such as muscle and…

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Disorders of Magnesium: Hypomagnesemia

Jun 20, 2017 by in NEPHROLOGY Comments Off on Disorders of Magnesium: Hypomagnesemia

Cause Mechanism Decreased intake Protein-calorie malnutrition Poor Mg2+ intake Starvation Poor Mg2+ intake Prolonged i.v. therapy without Mg2+ Poor Mg2+ intake Chronic alcoholism Possible mechanisms include: (1) poor dietary intake;…

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Disorders of Phosphate: Physiology

Jun 20, 2017 by in NEPHROLOGY Comments Off on Disorders of Phosphate: Physiology

Fig. 20.1 Phosphate homeostasis in an adult subject. (The filtered load of phosphate equals the free plasma concentration of 3.5 mg/dL multiplied by the GFR of 180 L per day, i.e., 180 L × 35 mg/L = 6,300 mg/day.)…

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