Metabolic acid-base disorders are comnom clinical problems in ICU patients. Arterial blood gas analysis and anion gap (AG) are important laboratory data in approaching acid-base interpretation. When measuring the AG, several factors such as albumin have influence on unmeasured anions and unmeasured cations. If a patient has hypoalbuminemia, the AG should be adjusted according to the albumin level. High AG metabolic acidoses including lactic acidosis, ketoacidosis, and ingestion of toxic alcohols are common in ICU patients. The treatment target of lactic acidosis and ketoacidosis is not the acidosis, but the underlying condition causing acidosis. Gastric acid loss, diuretics, volume depletion, renal compensation for respiratory acidosis, hypokalemia, and mineralocorticoid excess are common causes of metaboic alkalosis. In chloride responsive metaboic alkalosis, volume and potassium repletion are mandatory.
Acid-Base Equilibrium ; Acidosis ; Acidosis, Lactic ; Acidosis, Respiratory ; Alcohols ; Alkalosis ; Anions ; Blood Gas Analysis ; Cations ; Compensation and Redress ; Diuretics ; Eating ; Gastric Acid ; Humans ; Hypoalbuminemia ; Hypokalemia ; Ketosis ; Potassium

No abstract available.
Acidosis, Renal Tubular*

No abstract available.
Acidosis, Renal Tubular* ; Captopril*

No abstract available.
Acidosis, Renal Tubular*

Distal renal tubular acidosis (dRTA) is characterized by hyperchloremic hypokalemic metabolic acidosis, nephrocalcinosis and metabolic bone disease. It has been associated with Southeast Asian Ovalocytosis (SAO), particularly in malaria endemic region. We present a case of an older adult with dRTA who presented with respiratory failure as a result of hyperchloremic normal anion gap metabolic acidosis, in association with nephrocalcinosis and SAO, however, without hypokalaemia due to concurrent acute kidney injury. Oxygen therapy was able to be weaned off after treatment with alkali supplementation. Distal RTA may be associated with SAO, and early recognition and treatment of dRTA is paramount in preventing complications such as chronic kidney disease, metabolic bone disease and life-threatening respiratory arrest.
Acidosis, Renal Tubular

No abstract available.
Acidosis, Lactic*

No abstract available.
Acidosis, Lactic*

No abstract available.
Acidosis, Respiratory* ; Alkalosis, Respiratory*

Renal tubular acidosis is a clinical state of systemic hyperchloremic acidosis resulting from impaired urine acidification. Medullary sponge kidney is a renal parenchymal malformation characterized by cystic dilatation of the collecting ducts. Although medullary sponge kidney is a congenital disease, it is rarely identified in childhood and is usually discovered in adulthood. Medullary sponge kidney patients may have defects in urinary acidification and concentration mechanism. We experienced a case of distal renal tubular acidosis associated with medullary sponge kidney. So, we report a case of distal renal tubular acidosis associated with medullary sponge kidney with a brief review of the related literature.
Acidosis ; Acidosis, Renal Tubular* ; Dilatation ; Humans ; Medullary Sponge Kidney*

No abstract available.
Acetazolamide ; Acidosis ; Acidosis, Renal Tubular ; Hypokalemic Periodic Paralysis ; Muscle Weakness