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Metabolic acidosis

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https://www.readbyqxmd.com/read/28343312/role-of-acid-base-homeostasis-in-diabetic-kidney-disease
#1
REVIEW
Pascale Khairallah, Julia J Scialla
PURPOSE OF REVIEW: Acid-base homeostasis is impaired in chronic kidney disease (CKD) and may contribute to disease progression. Diabetes, a major cause of CKD worldwide, may exacerbate acidosis further due to differences in acid production and excretion. Here, we review the role of abnormal acid-base homeostasis in the pathogenesis and progression of diabetes and diabetic kidney disease. RECENT FINDINGS: Acidosis and dietary acid loading may contribute to the development and worsening of insulin resistance and hypertension, thereby promoting diabetes and diabetic CKD...
April 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28343228/focal-brain-injury-associated-with-a-model-of-severe-hypoxic-ischemic-encephalopathy-in-nonhuman-primates
#2
Ryan M McAdams, Ronald J McPherson, Raj P Kapur, Sandra E Juul
Worldwide, hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal mortality and morbidity. To better understand the mechanisms contributing to brain injury and improve outcomes in neonates with HIE, better preclinical animal models that mimic the clinical situation following birth asphyxia in term newborns are needed. In an effort to achieve this goal, we modified our nonhuman primate model of HIE induced by in utero umbilical cord occlusion (UCO) to include postnatal hypoxic episodes, in order to simulate apneic events in human neonates with HIE...
March 25, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28342684/persistent-pulmonary-hypertension-of-the-newborn
#3
REVIEW
Mamta Fuloria, Judy L Aschner
Failure of the normal circulatory adaptation to extrauterine life results in persistent pulmonary hypertension of the newborn (PPHN). Although this condition is most often secondary to parenchymal lung disease or lung hypoplasia, it may also be idiopathic. PPHN is characterized by elevated pulmonary vascular resistance with resultant right-to-left shunting of blood and hypoxemia. Although the preliminary diagnosis of PPHN is often based on differential cyanosis and labile hypoxemia, the diagnosis is confirmed by echocardiography...
March 23, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28337083/continuous-infusion-etomidate-in-a-patient-receiving-extracorporeal-membrane-oxygenation
#4
Joseph M LaRochelle, Bonnie Desselle, Janet L Rossi
We describe a 16-year-old, 65-kg male deployed on extracorporeal membrane oxygenation (ECMO) for refractory respiratory failure secondary to ingestion of multiple substances. During his ECMO course, standard sedative and analgesic strategies failed and alternative medications were used. The patient received various dosages of fentanyl, morphine, hydromorphone, clonidine patches, dexmedetomidine, lorazepam, methadone, pentobarbital, olanzapine, and propofol. Despite administration of multiple agents, on day 29 of ECMO the patient experienced elevated blood pressures due to agitation, and continuous infusion etomidate was started...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28333070/evaluation-of-mct1-mct4-and-cd147-genes-in-peripheral-blood-cells-of-breast-cancer-patients-and-their-potential-use-as-diagnostic-and-prognostic-markers
#5
Maria Cláudia de B Luz, Matheus M Perez, Ligia A Azzalis, Luiz Vinícius de A Sousa, Fernando Adami, Fernando L A Fonseca, Beatriz da C A Alves
BACKGROUND: Patients with breast cancer-the deadliest cancer among women-are at constant risk of developing metastasis. Oxidative stress and hypoxia are common feature of tumor cells that can proliferate even in a resultant metabolic acidosis. Despite the low extracellular pH, intracellular pH of tumor cells remains relatively normal, or even more alkaline due to the action of a membrane protein family known as monocarboxylate transporters (MCTs). The objective of this study was to verify the diagnostic and prognostic value of MCT1, MCT4 and CD147 in tumor and peripheral blood samples of patients with breast cancer undergoing chemotherapic treatment...
March 23, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28329904/-accumulation-of-metformin-associated-lactic-acidosis
#6
Tabea Rüegg, Basil Caduff
Objective Lactic acidosis has been associated with the use of metformin since its introduction. The cause, however, is highly controversial. The incidence of metformin-associated lactic acidosis (MALA) is quoted at 3,0 to 16,7 cases per 100 000 patient-years according to current studies. The link between metformin and lactic acidosis in metformin therapy has been suggested to be causal and therefore, the use of metformin was restricted to type 2 diabetic patients without renal impairment. Recent studies, however, show an acceptable use and no increased incidence of lactic acidosis in chronic mild to moderate renal insufficiency, respectively...
March 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28322687/correction-altered-mental-status-and-an-acid-base-disturbance
#7
Shylaja Mani, Gregory W Rutecki
In the article "A patient with altered mental status and an acid-base disturbance" (Mani S, Rutecki GW, Cleve Clin J Med 2017; 84:27-34), 2 errors occurred in Table 2. The corrected table appears with corrections shown in red. In addition, two sentences in the text regarding the osmol gap should be revised as follows: On page 31, the last 3 lines should read as follows: "When the anion gap metabolic acidosis is multifactorial, as it was suspected to be in a case reported by Tan et al,(23) the osmol gap may be elevated as a consequence of additional toxic ingestions, as it was in the reported patient...
March 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28320917/predictors-of-massive-blood-transfusion-a-delphi-study-to-examine-the-views-of-experts
#8
Jacqueline V Mclennan, K C Mackway-Jones, S T Horne, R Body
BACKGROUND: Trauma patients requiring massive blood transfusion (MBT) have high morbidity and mortality: early and aggressive use of blood products during immediate resuscitation may improve survival. There is currently a lack of evidence to guide initial identification of these patients which is especially important in areas where plasma may need to be thawed. In the absence of this evidence, this study aimed to robustly evaluate expert opinion by using a Delphi process to identify predictors of massive transfusion...
March 20, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28319329/extracellular-acidosis-and-very-low-na-inhibit-nbcn1-and-nhe1-mediated-net-acid-extrusion-from-mouse-vascular-smooth-muscle-cells
#9
Lisbeth Bonde, Ebbe Boedtkjer
AIM: The electroneutral Na(+) ,HCO3(-) -cotransporter NBCn1 and Na(+) /H(+) -exchanger NHE1 regulate acid-base balance in vascular smooth muscle cells (VSMCs) and modify artery function and structure. Pathological conditions-notably ischemia-can dramatically perturb intracellular (i) and extracellular (o) pH and [Na(+) ]. We examined effects of low [Na(+) ]o and pHo on NBCn1 and NHE1 activity in VSMCs of small arteries. METHODS: We measured pHi by 2',7'-bis-(2-carboxyethyl)-5-(and-6)-carboxyfluorescein-based fluorescence microscopy of mouse mesenteric arteries and induced intracellular acidification by NH4(+) -prepulse technique...
March 20, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28315119/alterations-of-mg-2-after-hemorrhagic-shock
#10
Mun-Young Lee, Dong Kwon Yang, Shang-Jin Kim
Hemorrhagic shock is generally characterized by hemodynamic instability with cellular hypoxia and diminishing cellular function, resulting from an imbalance between systemic oxygen delivery and consumption and redistribution of fluid and electrolytes. Magnesium (Mg) is the fourth most abundant cation overall and second most abundant intracellular cation in the body and an essential cofactor for the energy production and cellular metabolism. Data for blood total Mg (tMg; free-ionized, protein-bound, and anion-bound forms) and free Mg(2+) levels after a traumatic injury are inconsistent and only limited information is available on hemorrhagic effects on free Mg(2+) as the physiologically active form...
March 17, 2017: Biological Trace Element Research
https://www.readbyqxmd.com/read/28306518/biochemical-testing-in-a-laboratory-tent-and-semi-intensive-care-of-ebola-patients-on-site-in-a-remote-part-of-guinea-a-paradigm-shift-based-on-a-bleach-sensitive-point-of-care-device
#11
Leonid M Irenge, Jean-Michel Dindart, Jean-Luc Gala
BACKGROUND: During the West Africa Ebola virus disease (EVD) outbreak, a Belgian laboratory was deployed for supporting the Ebola treatment unit (ETU) of N'Zerekore, Guinea. Besides diagnosis of EVD and malaria, biochemical parameters were tested and used to guide supportive treatment of EVD. METHODS: To preserve analytes stability, lithium-heparin blood samples were analyzed using the i-STAT® point-of-care testing (POCT) handheld device without the viral inactivation step...
March 15, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28306366/serum-osmolal-gap-in-clinical-practice-usefulness-and-limitations
#12
George Liamis, Theodosios D Filippatos, Angelos Liontos, Moses S Elisaf
BACKGROUND: Although serum osmolal gap can be a useful diagnostic tool, clinicians are not familiar with its use in clinical practice. OBJECTIVES: The review presents in a series of questions-answers and under a clinical point of view the current data regarding the use of osmolal gap. DISCUSSION: The definition and the best formula used for the calculation of osmolal gap, the main causes of increased osmolal gap with or without increased anion gap metabolic acidosis, as well as the role of concurrent lactic acidosis or ketoacidosis are presented under a clinical point of view...
March 23, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28299023/the-effect-of-osmotherapy-and-tight-control-of-acidosis-on-early-graft-function-among-deceased-donor-kidney-transplant-recipients-a-randomized-controlled-trial
#13
F Etezadi, A H Najafi Abrandabadi, J Motaharinia, M Mojtahedzadeh, P Pourfakhr, M R Khajavi, S Gooran, R Shariat Moharari, S Dehghani
BACKGROUND: Reperfusion injury and the acid-base status of the transplant are important factors affecting post-transplantation graft function. OBJECTIVE: We hypothesized that infusing hypertonic saline (HS) or tight control of acid-base status of the blood rushing through renal graft using sodium bicarbonate may have beneficial effects on early graft function. METHODS: Candidates for deceased-donor kidney transplant were randomized into three groups...
2017: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/28298360/stimulation-of-fibroblast-growth-factor-23-by-metabolic-acidosis-requires-osteoblastic-intracellular-calcium-signaling-and-prostaglandin-synthesis
#14
Nancy S Krieger, David A Bushinsky
Serum fibroblast growth factor 23 (FGF23) increases progressively in chronic kidney disease (CKD) and is associated with increased mortality. FGF23 is synthesized in osteoblasts and osteocytes; however, the factors regulating its production are not clear. Patients with CKD have decreased renal acid excretion leading to metabolic acidosis (MET). During MET, acid is buffered by bone with release of mineral calcium (Ca) and phosphate (P). MET increases intracellular Ca signaling and cyclooxygenase 2 (COX2)-induced prostaglandin production in the osteoblast leading to decreased bone formation and increased bone resorption...
March 15, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28296160/changes-in-serum-bicarbonate-levels-caused-by-acetate-containing-bicarbonate-buffered-hemodialysis-solution-an-observational-prospective-cohort-study
#15
Mandip Panesar, Neal Shah, Sarosh Vaqar, Kaushik Ivaturi, Gregory Gudleski, Mary Muscarella, Judy Lambert, Winnie Su, Brian Murray
Fresenius Medical Care's NaturaLyte dialysate has been associated with increased risk of sudden cardiac death by causing metabolic alkalosis from its acetate content based on retrospective data using pre-dialysis bicarbonate levels only. The study objective was to measure inter/intra-dialytic changes in serum bicarbonate and degree of alkalosis conferred by varying concentrations of NaturaLyte bicarbonate dialysate. Thirty-nine hemodialysis patients were divided into four groups based on prescribed bicarbonate dialysate concentrations; Group 1 (N = 9): 30-32 mEq/L, Group 2 (N = 5): 33-34 mEq/L, Group 3 (N = 10): 35-36 mEq/L, Group 4 (N = 15): 37-40 mEq/L...
March 13, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28290972/malignant-hyperthermia-susceptibility-and-fitness-for-duty
#16
Michael A Lee, Erin B McGlinch, Maria C McGlinch, John F Capacchione
INTRODUCTION: Malignant hyperthermia (MH) is an inherited hypermetabolic condition characterized by uncontrolled calcium release from the sarcoplasmic reticulum of skeletal muscle, usually from exposure to inhaled general anesthetics and/or the depolarizing neuromuscular blocking agent succinylcholine. Multiple case reports now reveal that crises may be precipitated by environmental factors such as exercise or high ambient temperatures. Common signs of an MH crisis include life-threatening hyperthermia, metabolic acidosis, muscle rigidity, and tachycardia...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28289910/acid-base-disturbances-in-nephrotic-syndrome-analysis-using-the-co2-hco3-method-traditional-boston-model-and-the-physicochemical-method-stewart-model
#17
Tomomichi Kasagi, Hirokazu Imai, Naoto Miura, Keisuke Suzuki, Masabumi Yoshino, Hironobu Nobata, Takuhito Nagai, Shogo Banno
BACKGROUND: The Stewart model for analyzing acid-base disturbances emphasizes serum albumin levels, which are ignored in the traditional Boston model. We compared data derived using the Stewart model to those using the Boston model in patients with nephrotic syndrome. METHODS: Twenty-nine patients with nephrotic syndrome and six patients without urinary protein or acid-base disturbances provided blood and urine samples for analysis that included routine biochemical and arterial blood gas tests, plasma renin activity, and aldosterone...
March 13, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28288687/effectiveness-of-isosorbide-dinitrate-in-cyanide-poisoning-as-a-function-of-the-administration-timing
#18
Ophir Lavon, Amit Avrahami, Arik Eisenkraft
BACKGROUND: Better and safer antidotes against cyanide poisoning are needed. Prior study has shown a favorable effect of isosorbide dinitrate (ISDN) on the survival of cyanide-poisoned rabbits when administered as early as 1 min after poisoning. The aim of the current study was to further evaluate the efficacy of intravenous ISDN administered in clinically relevant timing for first responders. METHODS: A comparative animal study using 24 rabbits in 4 randomized study groups was performed...
March 14, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28286482/restoration-of-epithelial-sodium-channel-function-by-synthetic-peptides-in-pseudohypoaldosteronism-type-1b-mutants
#19
Anita Willam, Mohammed Aufy, Susan Tzotzos, Heinrich Evanzin, Sabine Chytracek, Sabrina Geppert, Bernhard Fischer, Hendrik Fischer, Helmut Pietschmann, Istvan Czikora, Rudolf Lucas, Rosa Lemmens-Gruber, Waheed Shabbir
The synthetically produced cyclic peptides solnatide (a.k.a. TIP or AP301) and its congener AP318, whose molecular structures mimic the lectin-like domain of human tumor necrosis factor (TNF), have been shown to activate the epithelial sodium channel (ENaC) in various cell- and animal-based studies. Loss-of-ENaC-function leads to a rare, life-threatening, salt-wasting syndrome, pseudohypoaldosteronism type 1B (PHA1B), which presents with failure to thrive, dehydration, low blood pressure, anorexia and vomiting; hyperkalemia, hyponatremia and metabolic acidosis suggest hypoaldosteronism, but plasma aldosterone and renin activity are high...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28284376/the-tubulointerstitial-pathophysiology-of-progressive-kidney-disease
#20
REVIEW
H William Schnaper
Accumulating evidence suggests that the central locus for the progression of CKD is the renal proximal tubule. As injured tubular epithelial cells dedifferentiate in attempted repair, they stimulate inflammation and recruit myofibroblasts. At the same time, tissue loss stimulates remnant nephron hypertrophy. Increased tubular transport workload eventually exceeds the energy-generating capacity of the hypertrophied nephrons, leading to anerobic metabolism, acidosis, hypoxia, endoplasmic reticulum stress, and the induction of additional inflammatory and fibrogenic responses...
March 2017: Advances in Chronic Kidney Disease
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