pediatrics.Renal tubular acidosis.(dr.adnan hamawandi)
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This document discusses renal tubular acidosis (RTA), a group of disorders characterized by hyperchloremic metabolic acidosis and tubular dysfunction. It describes the different types of RTA, including distal RTA (type I), proximal RTA (type II), and type IV RTA. Distal RTA is caused by a failure of the distal tubules to secrete dietary acid, leading to an inability to maximally acidify urine or generate new bicarbonate. Proximal RTA results from decreased proximal tubular resorption of bicarbonate. Type IV RTA involves defects in distal tubular secretion of hydrogen ions and potassium, causing hyperchloremic metabolic acidosis and hyperkal
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Renal tubular acidosis (RTA) is a group of disorders characterized by an inability of the kidney to resorb bicarbonate or secrete hydrogen ions, resulting in hyperchloremic metabolic acidosis with normal kidney function. There are four main types: type I is inability of the distal tubule to acidify urine; type II is a defect in proximal tubule bicarbonate reabsorption; type III has features of both type I and II; type IV is due to aldosterone deficiency or resistance. Treatment involves oral alkali supplementation to raise bicarbonate levels to normal.
Rta dr mahtab
This document provides information on renal tubular acidosis (RTA). It defines RTA as a metabolic acidosis with a normal glomerular filtration rate. It describes the different types of RTA, including distal (Type 1) RTA caused by impaired distal tubule acidification, proximal (Type 2) RTA caused by impaired proximal tubule bicarbonate reabsorption, and combined proximal and distal (Type 3) RTA. It discusses the etiology, pathophysiology, clinical manifestations, diagnosis and treatment of each RTA type. Primary causes include genetic disorders, while secondary causes include autoimmune diseases, toxins and obstructive uropathies. Clinical features include growth failure, nephro
6-1. Cystinosis. Elena Levtchenko (eng)
This document provides an overview of cystinosis, including its diagnosis, treatment, and outcomes. Cystinosis is an autosomal recessive disease caused by defective transport of cystine out of lysosomes, leading to cystine accumulation. It most commonly presents in infancy with renal Fanconi syndrome. Treatment involves symptomatic management of Fanconi syndrome and cysteamine therapy to deplete cystine levels. Earlier diagnosis and treatment with cysteamine has led to improved renal survival, with median kidney survival now over 10 years. However, compliance can be challenging due to cysteamine's adverse effects. New formulations aim to improve tolerability and outcomes. Long-term management also monitors for extra-renal complications affecting the eyes,
Renal tubular acidosis
Renal tubular acidosis (RTA) refers to defects in renal reabsorption of bicarbonate or excretion of hydrogen ions. There are different types of RTA based on the site of defect - proximal RTA involves impaired proximal tubule bicarbonate reabsorption leading to metabolic acidosis, while distal RTA involves impaired distal tubule hydrogen ion secretion. Evaluation of RTA involves assessing urine pH, bicarbonate handling, and distinguishing between proximal versus distal defects. Treatment depends on the RTA type and involves oral bicarbonate and potassium supplementation.
Rta 18.05.16
This document summarizes a seminar on renal tubular acidosis (RTA). It includes two case scenarios of children presenting with features of RTA like failure to thrive and metabolic acidosis. Investigation of the cases showed metabolic acidosis with normal anion gap, hypokalemia, and hyperchloremia, consistent with RTA. The seminar discusses normal acid-base homeostasis, types and causes of RTA, pathophysiology of proximal and distal RTA, and clinical features of different types of RTA. Diagnosis involves evaluation of urine pH, bicarbonate threshold, and distinguishing features of different subtypes.
Acute tubular necrosis
This document provides background information on acute tubular necrosis (ATN). It defines ATN and describes its causes, which can be ischemic or nephrotoxic in nature. The pathophysiology of ATN involves three phases: initiation, maintenance, and recovery. Ischemic ATN is described as occurring on a spectrum with prerenal azotemia. Nephrotoxic ATN involves direct toxicity to tubular cells. Histological examination shows differences between ischemic and toxic forms of ATN. Risk factors, history, physical exam findings, and common causes of ischemic and nephrotoxic ATN are discussed.
Acidosis tubular renal
La paciente presenta acidosis metabólica con hiperclorémica y pH urinario bajo, lo que sugiere un defecto en la secreción distal de protones. Esto es consistente con un diagnóstico de acidosis tubular renal distal, en la cual hay una incapacidad para disminuir adecuadamente el pH urinario a pesar de la acidosis sistémica.
Disease affecting tubules and interstitium
This document discusses disease affecting the renal tubules and interstitium. It begins by explaining that tubular injury often also involves the interstitium and can be inflammatory, as seen in interstitial nephritis, or ischemic, as seen in acute tubular necrosis. The document then goes on to describe various specific diseases in more detail, including tubulointerstitial nephritis of infectious and non-infectious origin, acute and chronic pyelonephritis, drug-induced interstitial nephritis, and analgesic nephropathy. It also provides morphological and clinical details of acute tubular necrosis.
Non-anion gap Metabolic Acidosis (NAGMA)
The document discusses different types of metabolic acidosis, including non-anion gap metabolic acidosis (NAGMA) and renal tubular acidosis (RTA). It provides details on evaluating acid-base imbalances and determining if a metabolic acidosis is respiratory or metabolic. Causes of NAGMA include loss of bicarbonate from the GI tract or kidneys. Proximal and distal RTA can result from different defects in renal bicarbonate reabsorption and new bicarbonate production.
Acute tubular necrosis
This document discusses tubular and interstitial diseases, focusing on acute kidney injury (AKI) and acute tubular necrosis (ATN). It provides details on:
1) The pathogenesis of AKI involving tubular cell injury from ischemia or toxins, disturbances in blood flow causing vasoconstriction, and the repair process through growth factors and cytokines.
2) The morphology of ischemic AKI, seen as focal tubular necrosis and casts, and the morphology of toxic AKI varying by toxin but often involving necrosis.
3) The clinical course of AKI proceeding through initiation, maintenance, and recovery phases and sometimes being nonoliguric. Prognosis depends on the cause,
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Renal tubular acidosis and other causes of Normal anion gap Metabolic acidosis
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Similar to pediatrics.Renal tubular acidosis.(dr.adnan hamawandi)
Acid Base Balance.pptx
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Vg Ab
Acid-base balance is defined by the concentration of hydrogen ions in the body and is maintained through a balance of hydrogen ion intake/production and removal. The body defends against fluctuations in pH through buffer systems in the blood, respiration through the lungs, and excretion by the kidneys. There are four types of acid-base imbalances: respiratory alkalosis, respiratory acidosis, metabolic alkalosis, and metabolic acidosis.
5-Acid-Base-2022.pptx
This document discusses acid-base disorders and summarizes key points about acid-base balance, buffers, and the mechanisms that maintain homeostasis. It covers the respiratory, renal, and extracellular buffering systems and how they compensate for acid-base imbalances. Metabolic acidosis is discussed in depth, including causes like renal tubular acidosis and lactic acidosis. Treatment focuses on correcting the underlying disorder and using oral or intravenous sodium bicarbonate to gradually normalize pH.
Acid base imbalance
Acid-base imbalance occurs when the pH of the blood plasma deviates from the normal range of 7.35-7.45 due to excess acids or bases. There are four main types of acid-base imbalance: respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis. These can be caused by conditions affecting respiration or the kidneys. Symptoms depend on the type of imbalance. Diagnosis involves blood tests and other assessments. The body compensates through buffer systems, breathing, and kidney function, but severe imbalances can damage cells.
Metabolic acidosis by akram
Metabolic acidosis can be caused by increased acid production, decreased acid excretion, or bicarbonate loss. It is classified as high or normal anion gap and treated by addressing the underlying cause, replacing losses, and using bicarbonate supplementation in emergencies. Lactic acidosis, diabetic ketoacidosis, and renal tubular acidosis require specific management such as fluids, insulin, electrolyte replacement, or bicarbonate therapy. The prognosis depends on the cause, with appropriate treatment helping recovery but sometimes leading to organ dysfunction or failure.
Case Study On Acid Base Metabolic Acidosis
This document discusses a case of metabolic acidosis. Metabolic acidosis occurs when the body produces too much acid or loses too much bicarbonate. The bicarbonate buffer system helps regulate pH by reversibly binding hydrogen ions. When this system is overwhelmed, the body can compensate by hyperventilating to expel excess carbon dioxide, driving the bicarbonate buffer reaction rightward to reduce hydrogen ions and raise pH. The kidneys also help compensate by reabsorbing bicarbonate and secreting more hydrogen ions. Metabolic acidosis causes potassium to shift intracellularly, lowering extracellular potassium levels, which must be tightly regulated for cell function.
Acid Base Balance. An important topic in Physiologypptx
Acid Base Balance. An important topic in PhysiologypptxRawal Institute of Health Sciences, ISLAMABAD - PAKISTAN
The document discusses acid-base balance in the human body. It explains that acids release hydrogen ions and bases accept hydrogen ions. The body tightly regulates pH through various buffer systems, including bicarbonate, phosphate, proteins, hemoglobin, respiratory, and renal. Imbalances can occur if pH falls below 6.8 or rises above 8.0 and are compensated for by these buffer systems to maintain homeostasis. The kidneys play an important role in regulating blood pH by controlling bicarbonate reabsorption and acid excretion.fisopatologia del acido base
This document discusses acid-base disorders caused by renal processes. It summarizes that acid-base homeostasis is critical for normal bodily functions and is maintained through respiration and the kidneys. The kidneys play a central role through reabsorbing filtered bicarbonate, excreting acid as ammonium and titratable acidity, and generating new bicarbonate. Inherited disorders can disrupt acid-base balance by affecting transporters in the proximal tubule or distal tubule. More common renal acidosis occurs in advanced chronic kidney disease due to reduced ammonia generation.
Metbolic acidosis and alkalosis
The document discusses why a blood pH between 7.35-7.45 is important for optimal cellular function, the mechanisms that regulate acid-base balance, and types of acid-base disorders including metabolic acidosis, respiratory acidosis, and metabolic alkalosis. Evaluation of acid-base disorders involves analyzing the anion gap and identifying underlying causes, while treatment focuses on correcting the primary disturbance and any electrolyte abnormalities.
Metabolic acidosis
This document discusses metabolic acidosis, a condition caused by excessive acid production or inadequate removal of acid from the body. It causes a low blood pH (below 7.35). Symptoms are non-specific but can include altered mental status and respiratory changes. Diagnosis involves blood gas analysis showing low bicarbonate and pH. The anion gap is used to classify types of metabolic acidosis as high, normal, or low. Treatment focuses on resolving the underlying cause while supporting organ function through respiratory and renal compensation mechanisms.
A new perspective on metabolic acidosis
This document provides an overview of acid-base disorders and metabolic acidosis. It discusses:
1. Normal acid-base balance parameters and the basic regulation of acid-base balance by the lungs and kidneys.
2. The different types of acids in the body including volatile, fixed, organic, and toxic acids. Metabolic acidosis is often caused by organic acids like ketoacids, lactic acid, or toxic acids.
3. Diagnosis of metabolic acidosis including anion gap, serum osmolar gap, and urine anion gap measurements. Common causes of increased or decreased anion gap acidosis are described.
4. Treatment principles for metabolic acidosis including conservative b
Lect 4 electrolytes & balance
This document provides an overview of electrolytes, water, and acid-base balance disorders. It discusses the distribution and composition of body fluids, disturbances in water and electrolyte balance like dehydration and electrolyte abnormalities, and disturbances in acid-base balance including respiratory and metabolic acidosis and alkalosis. Measurement techniques for electrolytes, fluid volumes, and acid-base balance in blood and other samples are also summarized.
Fluid and electrolyte management in surgical patients.
Fluid and electrolyte management has to be aggressive. It is pivitol in speedy recovery in GI surgery. Changes should be anticipated and treated promptly. A detailed knowledge of this is essential for optimum management especially in the ICU.
Composition of Human Body _ Body Fluids and Electrolytes.pptx
The document discusses the composition and regulation of fluids, electrolytes, and acid-base balance in the human body. It covers the following key points:
1) The human body is composed of water, proteins, lipids, carbohydrates, and other materials. Water makes up about 60% of body weight and is distributed between intracellular and extracellular fluid compartments.
2) Major electrolytes like sodium, potassium, calcium, and phosphorus are distributed between intracellular and extracellular fluids and their concentrations are tightly regulated.
3) The body maintains acid-base balance through buffering systems like protein, carbonic acid-bicarbonate, and phosphate buffers that control hydrogen ion concentration in fluids.
4
Acid base disorders, renal tubular acidosis &
This document discusses acid-base physiology and disorders. It begins by explaining how carbon dioxide and volatile and non-volatile acids are produced daily through metabolism. It then defines volatile and non-volatile acids. The document goes on to discuss various calculations used to interpret acid-base disorders, including anion gap, delta ratio, osmolal gap, and urine anion gap. It explains the causes and characteristics of metabolic acidosis and alkalosis, including mixed disorders. Throughout, it provides examples of how to approach and diagnose complex acid-base imbalances.
Arterial blood gas analysis
Dr. Y. Krishna presented on arterial blood gas analysis. Key points include:
- ABG analysis provides pH, PaCO2, PaO2, HCO3, SaO2 and other values to assess acid-base status and ventilation.
- Primary acid-base disorders involve changes in PaCO2 or HCO3, while secondary involve compensatory changes. Acute vs chronic compensation affects HCO3 changes.
- Anion gap is used to determine if metabolic acidosis is due to organic acids or HCO3 loss. Delta gap identifies additional hidden processes.
- Common causes of acid-base imbalances include respiratory disorders like hypoventilation; and metabolic disorders like ketoacidosis
A new perspective on metabolic acidosis
This document discusses metabolic acidosis and renal tubular acidosis. It begins by explaining normal acid-base balance and the various buffer systems that help regulate pH, including the bicarbonate buffer system, phosphate buffer system, and ammonia buffer system. It then describes different types of acids in the body and the mechanisms of acid excretion by the kidneys. The document analyzes various types of acid-base disturbances and renal tubular acidosis, providing details on causes, clinical presentations, and treatments. In summary, it provides a comprehensive overview of acid-base physiology and the pathophysiology of metabolic acidosis and renal tubular acidosis.
Regualtion of Acid base balance.pptx
This document discusses regulation of acid-base balance in the body. It covers:
1) Various buffers that help maintain blood pH within a narrow range, including bicarbonate, phosphate, and proteins. Bicarbonate acts as the primary extracellular buffer.
2) Mechanisms for pH regulation, including respiratory changes that release or retain CO2, and renal mechanisms like reabsorbing bicarbonate and excreting acid.
3) Types of acid-base disorders like metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis, which can occur alone or in combination. Clinical evaluation involves analyzing pH, bicarbonate, and CO2 levels.
Arterial blood gas analysis (ABG)
An arterial-blood gas test measures the amounts of arterial gases, such as oxygen and carbon dioxide. An ABG test requires that a small volume of blood be drawn from the radial artery with a syringe and a thin needle, but sometimes the femoral artery in the groin or another site is used.
The common indications for ABGs are:
Respiratory compromise, which leads to hypoxia or diminished ventilation.
Peri- or postcardiopulmonary arrest or collapse.
Medical conditions that cause significant metabolic derangement, such as sepsis, diabetic ketoacidosis, renal failure, heart failure, toxic substance ingestion, drug overdose, trauma, or burns.
Evaluating the effectiveness of therapies, monitoring the patient's clinical status, and determining treatment needs. For instance, clinicians often titrate oxygenation therapy, adjust the level of ventilator support, and make decisions about fluid and electrolyte therapy based on ABG results.
During the perioperative phase of major surgeries, which includes the preoperative, intraoperative, and postoperative care of the patient.
The components of an ABG analysis are PaO2, SaO2, hydrogen ion concentration (pH), PaCO2, HCO3-, base excess, and serum levels of hemoglobin, lactate, glucose, and electrolytes (sodium, potassium, calcium, and chloride).
Similar to pediatrics.Renal tubular acidosis.(dr.adnan hamawandi) (20)
Acid Base Balance. An important topic in Physiologypptx
Acid Base Balance. An important topic in Physiologypptx
reference of the metabolic siorder lactic acidosis .pdf
reference of the metabolic siorder lactic acidosis .pdf
Fluid and electrolyte management in surgical patients.
Fluid and electrolyte management in surgical patients.
Composition of Human Body _ Body Fluids and Electrolytes.pptx
Composition of Human Body _ Body Fluids and Electrolytes.pptx
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