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Homeostasis

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44 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29619878/measurement-of-daily-sodium-excretion-in-patients-with-chronic-kidney-disease-special-reference-to-the-difference-between-the-amount-measured-from-24-h-collected-urine-sample-and-the-estimated-amount-from-a-spot-urine
#1
Hoichi Amano, Seiji Kobayashi, Hiroyuki Terawaki, Makoto Ogura, Yoshindo Kawaguchi, Takashi Yokoo
It is important to grasp a patient's daily sodium intake in the management of chronic kidney disease, as sodium intake is widely recommended at 6 g/day or less. There are multiple equations widely known for estimating the daily sodium excretion from a spot urine sample, but these are aimed at healthy people. There are few reports that validate equations in patients with chronic kidney disease. The purpose of this study is to evaluate whether the amount of measured daily sodium excretion from a sample collected for 24-h urine (24HU) is equal to that of using an equation from a spot urine sample (SU) in patients with chronic kidney disease...
November 2018: Renal Failure
https://www.readbyqxmd.com/read/29606267/-which-biological-parameters-for-volemic-status-estimation
#2
Marion Vallet, Acil Jaafar, Pierre-Yves Charles, Ivan Tack
INTRODUCTION: Estimation of volemic status can be useful in the diagnosis of some hydro-electrolytic disorders such as hyponatremia and dyskalemia. As a matter of fact, clinical examination and classical biological parameters are not discriminant enough. The aim of this study was to determine the biological parameters that are better correlated to volemic status. METHOD: Volemic status was established using extracellular fluid volume, measured by apparent distribution of inuline, in non-edematous patients and without cardiac or hepatic insufficiency...
April 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29589268/changes-in-trace-elements-during-early-stages-of-chronic-kidney-disease-in-type-2-diabetic-patients
#3
Ching-Chiang Lin, Ching-Tang Shih, Chien-Hung Lee, Yeou-Lih Huang
Trace elements can influence glucose metabolism and be related to oxidative stress in type 2 diabetes mellitus. Moreover, trace elements play important roles in the nephrotic complications of these patients. Nevertheless, few investigations have been made into the changes in the levels of trace elements in diabetic patients at various stages of chronic kidney disease (CKD). The aims of this present study were to determine the levels of some important trace elements in diabetic patients during the early stages of CKD and to identify the relationship between these elements and CKD progression in type 2 diabetic patients...
March 28, 2018: Biological Trace Element Research
https://www.readbyqxmd.com/read/29357414/effects-of-a-high-sodium-low-potassium-diet-on-renal-calcium-magnesium-and-phosphate-handling
#4
Jenny van der Wijst, Omar A Z Tutakhel, Caro Bos, A H Jan Danser, Ewout J Hoorn, Joost G J Hoenderop, René J M Bindels
The distal convoluted tubule (DCT) of the kidney plays an important role in blood pressure regulation by modulating Na+ reabsorption via the Na+-Cl- cotransporter (NCC). A diet containing high salt (NaCl) and low K+ activates NCC, thereby causing Na+ retention and a rise in blood pressure. Since high blood pressure, hypertension, is associated with changes in serum calcium (Ca2+) and magnesium (Mg2+) levels, we hypothesized that dietary Na+ and K+ intake affects Ca2+ and Mg2+ transport in the DCT. Therefore, the present study aimed to investigate the effect of a high Na+/low K+ diet on renal Ca2+ and Mg2+ handling...
January 10, 2018: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29344508/acid-base-and-electrolyte-disorders-in-patients-with-and-without-chronic-kidney-disease-an-update
#5
REVIEW
Tsering Dhondup, Qi Qian
Kidneys play a pivotal role in the maintenance and regulation of acid-base and electrolyte homeostasis, which is the prerequisite for numerous metabolic processes and organ functions in the human body. Chronic kidney diseases compromise the regulatory functions, resulting in alterations in electrolyte and acid-base balance that can be life-threatening. In this review, we discuss the renal regulations of electrolyte and acid-base balance and several common disorders including metabolic acidosis, alkalosis, dysnatremia, dyskalemia, and dysmagnesemia...
December 2017: Kidney Diseases
https://www.readbyqxmd.com/read/29029808/potassium-homeostasis-in-health-and-disease-a-scientific-workshop-cosponsored-by-the-national-kidney-foundation-and-the-american-society-of-hypertension
#6
Csaba P Kovesdy, Lawrence J Appel, Morgan E Grams, Lisa Gutekunst, Peter A McCullough, Biff F Palmer, Bertram Pitt, Dominic A Sica, Raymond R Townsend
While much emphasis, and some controversy, centers on recommendations for sodium intake, there has been considerably less interest in recommendations for dietary potassium intake, in both the general population and patients with medical conditions, particularly acute and chronic kidney disease. Physiology literature and cohort studies have noted that the relative balance in sodium and potassium intakes is an important determinant of many of the sodium-related outcomes. A noteworthy characteristic of potassium in clinical medicine is the extreme concern shared by many practitioners when confronted by a patient with hyperkalemia...
December 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29030153/potassium-homeostasis-in-health-and-disease-a-scientific-workshop-cosponsored-by-the-national-kidney-foundation-and-the-american-society-of-hypertension
#7
Csaba P Kovesdy, Lawrence J Appel, Morgan E Grams, Lisa Gutekunst, Peter A McCullough, Biff F Palmer, Bertram Pitt, Dominic A Sica, Raymond R Townsend
While much emphasis, and some controversy, centers on recommendations for sodium intake, there has been considerably less interest in recommendations for dietary potassium intake, in both the general population and patients with medical conditions, particularly acute and chronic kidney disease. Physiology literature and cohort studies have noted that the relative balance in sodium and potassium intakes is an important determinant of many of the sodium-related outcomes. A noteworthy characteristic of potassium in clinical medicine is the extreme concern shared by many practitioners when confronted by a patient with hyperkalemia...
December 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/29102372/renal-potassium-physiology-integration-of-the-renal-response-to-dietary-potassium-depletion
#8
REVIEW
Kamel S Kamel, Martin Schreiber, Mitchell L Halperin
We summarize the current understanding of the physiology of the renal handling of potassium (K+ ), and present an integrative view of the renal response to K+ depletion caused by dietary K+ restriction. This renal response involves contributions from different nephron segments, and aims to diminish the rate of excretion of K+ as a result of: decreasing the rate of electrogenic (and increasing the rate of electroneutral) reabsorption of sodium in the aldosterone-sensitive distal nephron (ASDN), decreasing the abundance of renal outer medullary K+ channels in the luminal membrane of principal cells in the ASDN, decreasing the flow rate in the ASDN, and increasing the reabsorption of K+ in the cortical and medullary collecting ducts...
January 2018: Kidney International
https://www.readbyqxmd.com/read/29063671/magnesium-supplementation-a-consideration-in-dialysis-patients
#9
EDITORIAL
Mugurel Apetrii, Adrian Covic, Ziad A Massy
Even though disorders of magnesium (Mg) balance are common in dialyzed patients, this cation is often neglected. Many factors interfere with serum magnesium including diet, medications (eg, antacids or phosphate binders), and the dialysis prescription. Mg supplementation may help reduce serum phosphate concentration, PTH, and interfere with vascular calcification and bone mineralization. It could also decrease the all-cause and cardiovascular mortalities, although the results of current studies are conflicting...
January 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29031355/adverse-effects-of-the-metabolic-acidosis-of-chronic-kidney-disease
#10
REVIEW
Jeffrey A Kraut, Nicolaos E Madias
The kidney has the principal role in the maintenance of acid-base balance, and therefore, a fall in renal net acid excretion and positive H+ balance often leading to reduced serum [HCO3 - ] are observed in the course of CKD. This metabolic acidosis can be associated with muscle wasting, development or exacerbation of bone disease, hypoalbuminemia, increased inflammation, progression of CKD, protein malnutrition, alterations in insulin, leptin, and growth hormone, and increased mortality. Importantly, some of the adverse effects can be observed even in the absence of overt hypobicarbonatemia...
September 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29031353/regulation-of-acid-base-balance-in-chronic-kidney-disease
#11
REVIEW
Glenn T Nagami, L Lee Hamm
The kidneys play a major role in the regulation of acid-base balance by reabsorbing bicarbonate filtered by the glomeruli and excreting titratable acids and ammonia into the urine. In CKD, with declining kidney function, acid retention and metabolic acidosis occur, but the extent of acid retention depends not only on the degree of kidney impairment but also on the dietary acid load. Acid retention can occur even when the serum bicarbonate level is apparently normal. With reduced kidney function, acid transport processes in the surviving nephrons are augmented but as disease progresses ammonia excretion and, in some individuals, the ability to reabsorb bicarbonate falls, whereas titratable acid excretion is preserved until kidney function is severely impaired...
September 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29030467/metabolic-acidosis-and-subclinical-metabolic-acidosis-in-ckd
#12
Kalani L Raphael
Metabolic acidosis is not uncommon in CKD and is linked with bone demineralization, muscle catabolism, and higher risks of CKD progression and mortality. Clinical practice guidelines recommend maintaining serum total CO2 at ≥22 mEq/L to help prevent these complications. Although a definitive trial testing whether correcting metabolic acidosis improves clinical outcomes has not been conducted, results from small, single-center studies support this notion. Furthermore, biologic plausibility supports the notion that a subset of patients with CKD have acid-mediated organ injury despite having a normal serum total CO2 and might benefit from oral alkali before overt acidosis develops...
February 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28899602/an-increasingly-complex-relationship-between-salt-and-water
#13
EDITORIAL
Evan C Ray, Thomas R Kleyman
No abstract text is available yet for this article.
November 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28879535/hypercalcemia-a-consultant-s-approach
#14
Ari Auron, Uri S Alon
Due to their daily involvement in mineral metabolism, nephrologists are often asked to consult on children with hypercalcemia. This might become even more pertinent when the hypercalcemia is associated with acute kidney injury and/or hypercalciuria and renal calcifications. The best way to assess the severity of hypercalcemia is by measurement of plasma ionized calcium, and if not available by adjusting serum total calcium to albumin concentration. The differential diagnosis of the possible etiologies of the disturbance in the mineral homeostasis starts with the assessment of serum parathyroid hormone concentration, followed by that of vitamin D metabolites in search of both genetic and acquired etiologies...
September 6, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28729033/metabolic-acidosis-is-common-and-associates-with-disease-progression-in-children-with-chronic-kidney-disease
#15
Jérôme Harambat, Kevin Kunzmann, Karolis Azukaitis, Aysun K Bayazit, Nur Canpolat, Anke Doyon, Ali Duzova, Anna Niemirska, Betul Sözeri, Daniela Thurn-Valsassina, Ali Anarat, Lucie Bessenay, Cengiz Candan, Amira Peco-Antic, Alev Yilmaz, Sibylle Tschumi, Sara Testa, Augustina Jankauskiene, Hakan Erdogan, Alejandra Rosales, Harika Alpay, Francesca Lugani, Klaus Arbeiter, Francesca Mencarelli, Aysel Kiyak, Osman Dönmez, Dorota Drozdz, Anette Melk, Uwe Querfeld, Franz Schaefer
Recent studies in adult chronic kidney disease (CKD) suggest that metabolic acidosis is associated with faster decline in estimated glomerular filtration rate (eGFR). Alkali therapies improve the course of kidney disease. Here we investigated the prevalence and determinants of abnormal serum bicarbonate values and whether metabolic acidosis may be deleterious to children with CKD. Associations between follow-up serum bicarbonate levels categorized as under 18, 18 to under 22, and 22 or more mmol/l and CKD outcomes in 704 children in the Cardiovascular Comorbidity in Children with CKD Study, a prospective cohort of pediatric patients with CKD stages 3-5, were studied...
December 2017: Kidney International
https://www.readbyqxmd.com/read/28692217/-magnesium-in-daily-practice
#16
Dany Minetto, Jacques Serratrice, Jérôme Stirnemann
The magnesium is the 4th cation in the human body behind sodium, potassium and calcium. It is often referred to as the forgotten cation of modern medicine because of a lack of knowledge about its physiology and its potential medical use. Recent medical literature has shown renewed interest for the magnesium with publications about its role in diversified fields from prevention of muscular cramps, cardiovascular risk factors prevention trough to neuroprotection in stroke. However, we cannot recommend the use of magnesium in adults in our clinical practice, beyond the simple correction of hypomagnesemia, pre-eclampsia and possibly the treatment of torsades de pointes...
October 19, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28599903/metabolic-acidosis-or-respiratory-alkalosis-evaluation-of-a-low-plasma-bicarbonate-using-the-urine-anion-gap
#17
Daniel Batlle, Jamie Chin-Theodorou, Bryan M Tucker
Hypobicarbonatemia, or a reduced bicarbonate concentration in plasma, is a finding seen in 3 acid-base disorders: metabolic acidosis, chronic respiratory alkalosis and mixed metabolic acidosis and chronic respiratory alkalosis. Hypobicarbonatemia due to chronic respiratory alkalosis is often misdiagnosed as a metabolic acidosis and mistreated with the administration of alkali therapy. Proper diagnosis of the cause of hypobicarbonatemia requires integration of the laboratory values, arterial blood gas, and clinical history...
September 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28450695/hyperphosphatemia-a-cause-of-high-anion-gap-metabolic-acidosis-report-of-a-case-and-review-of-the-literature
#18
REVIEW
Seyed Ali Sadjadi, Alexander Pi
BACKGROUND Hyperphosphatemia is a common problem in patients with kidney failure. It is usually mild and rarely severe enough to cause metabolic acidosis on its own. Besides kidney failure, use of phosphate containing enemas, rhabdomyolysis, and tumor lysis syndrome are common causes of severe hyperphosphatemia. CASE REPORT A 74-year-old man with a history of diabetes mellitus type II, arterial hypertension, and end stage renal disease, who was on hemodialysis and who had undergone hemicolectomy for ischemic bowel disease, and had not eaten for several days, developed severe metabolic acidosis, with an anion gap (AG) of 31 meq/L, -uncorrected for serum albumin...
April 28, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/27590096/assessing-acid-base-status-physiologic-versus-physicochemical-approach
#19
Horacio J Adrogué, Nicolaos E Madias
The physiologic approach has long been used in assessing acid-base status. This approach considers acids as hydrogen ion donors and bases as hydrogen ion acceptors and the acid-base status of the organism as reflecting the interaction of net hydrogen ion balance with body buffers. In the physiologic approach, the carbonic acid/bicarbonate buffer pair is used for assessing acid-base status and blood pH is determined by carbonic acid (ie, Paco2 ) and serum bicarbonate levels. More recently, the physicochemical approach was introduced, which has gained popularity, particularly among intensivists and anesthesiologists...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/26901864/osmoregulation-during-long-term-fasting-in-lungfish-and-elephant-seal-old-and-new-lessons-for-the-nephrologist
#20
REVIEW
Bernard C Rossier
Vertebrates control the osmolality of their extra- and intra-cellular compartments despite large variations in salt and water intake. Aldosterone-dependent sodium reabsorption and vasopressin-dependent water transport in the distal nephron and collecting duct play a critical role in the final control of sodium and water balance. Long-term fasting (no eating, no drinking) represents an osmotic challenge for survival. Evolution has found very different solutions to meet this challenge. To illustrate this point, I will discuss osmoregulation of a mammal (elephant seal pup) and of a fish (lungfish) that are able to survive long-term fasting for months or even years...
2016: Nephron
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