704 results match your criteria Hyperchloremic Acidosis


[Perioperative Infusion Therapy in Children].

Anasthesiol Intensivmed Notfallmed Schmerzther 2020 May 20;55(5):324-333. Epub 2020 May 20.

The composition and type of intravenous fluids during paediatric anaesthesia have been subjects of debates for decades. Errors in perioperative infusion therapy in children may lead to serious complications and a negative outcome. Therefore, in this review historical and recent developments and recommendations for perioperative fluid management in children are presented, based on physiology and focused on safety and efficacy. Read More

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http://dx.doi.org/10.1055/a-1068-8566DOI Listing

Atypical clinical presentation of distal renal tubular acidosis: a case report registered in Amazonas, Brazil.

J Bras Nefrol 2020 Apr 27. Epub 2020 Apr 27.

Universidade Federal do Amazonas, Hospital Universitário Getúlio Vargas, Manaus, AM, Brasil.

We report an unusual case of a 24-year-old girl with a history of recurrent hypokalemic paralysis episodes and skin lesions on the lower limbs and buttocks, both of which had an acute evolution. In subsequent investigations, the patient also had nephrocalcinosis, nephrolithiasis, hyperchloremic metabolic acidosis and persistent alkaline urinary pH. The findings were consistent with distal renal tubular acidosis as the cause of hypokalemic paralysis. Read More

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http://dx.doi.org/10.1590/2175-8239-JBN-2019-0224DOI Listing

Spironolactone-furosemide combination therapy and acid-base disorders in liver cirrhosis patients
.

Int J Clin Pharmacol Ther 2020 May;58(5):261-267

Objective: Respiratory alkalosis (RA) and dilutional hyperchloremic acidosis (DHA) are the most common acid-base balance (ABB) disorders in patients with liver cirrhosis. The aims of this study were to clarify whether RA develops in relation to DHA via respiratory compensation of metabolic acidosis and whether spironolactone in combination with low-dose furosemide - diuretics known to ameliorate DHA - positively affects RA in liver cirrhosis patients.

Materials And Methods: 59 patients with advanced cirrhosis were divided into two groups. Read More

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http://dx.doi.org/10.5414/CP203624DOI Listing

High-anion gap hyperchloremic acidosis mimicking diabetic ketoacidosis on initial presentation - Case report.

Afr J Emerg Med 2020 Mar 17;10(1):46-47. Epub 2019 Nov 17.

Emergency & ICU Department, Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania.

Introduction: Diabetic ketoacidosis (DKA) often becomes the primary focus and in turn masks a similar serious condition like hyperchloremic metabolic acidosis.

Case Report: A 20 years old female with type 1 diabetes mellitus presented to the emergency department (ED) with signs and symptoms corresponding to DKA. Initial pH, HCO Na and Cl concentrations were 6. Read More

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http://dx.doi.org/10.1016/j.afjem.2019.09.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058869PMC

Association between perioperative normal saline and delayed graft function in deceased-donor kidney transplantation: a retrospective observational study.

Can J Anaesth 2020 Apr 27;67(4):421-429. Epub 2020 Jan 27.

Department of Anesthesia and Critical Care, Pontchaillou, University Hospital of Rennes, Rennes, France.

Purpose: Isotonic 0.9% sodium chloride (normal saline; NS) solution use is common, but its high chloride content has been shown to contribute to acid-base disturbances and acute kidney injury (AKI). As kidney transplant recipients are at high risk of postoperative AKI and renal replacement therapy, we aimed to evaluate the impact of perioperative NS administration on graft function after kidney transplantation. Read More

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http://dx.doi.org/10.1007/s12630-020-01577-9DOI Listing

Saline versus Lactated Ringer's Solution: The Saline or Lactated Ringer's (SOLAR) Trial.

Anesthesiology 2020 04;132(4):614-624

From the Department of General Anesthesiology (K.M., A.T., W.A.S.E., K.R., S.B., A.G.K., M.R.R., T.K., G.R.B., A.K.) Department of Outcomes Research (K.M., A.T., N.M., C.M., K.R., H.E., B.C., I.S., G.R.B., D.C., E.J.M., A.K., D.I.S.) Department of Quantitative Health Sciences (N.M., C.M., E.J.M.) Department of Orthopedic Surgery (C.H.-R.), Cleveland Clinic, Cleveland, Ohio the Division of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, Florida (L.S.) the Division of Anesthesia, Critical Care, and Pain Management, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel (B.C.) the Department of Anesthesia, St. Elizabeth's Medical Center, Boston, Massachusetts (I.S.).

Background: Both saline and lactated Ringer's solutions are commonly given to surgical patients. However, hyperchloremic acidosis consequent to saline administration may provoke complications. The authors therefore tested the primary hypothesis that a composite of in-hospital mortality and major postoperative complications is less common in patients given lactated Ringer's solution than normal saline. Read More

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http://dx.doi.org/10.1097/ALN.0000000000003130DOI Listing

Whole exome sequencing identified ATP6V1C2 as a novel candidate gene for recessive distal renal tubular acidosis.

Kidney Int 2020 Mar 22;97(3):567-579. Epub 2019 Oct 22.

Division of Nephrology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address:

Distal renal tubular acidosis is a rare renal tubular disorder characterized by hyperchloremic metabolic acidosis and impaired urinary acidification. Mutations in three genes (ATP6V0A4, ATP6V1B1 and SLC4A1) constitute a monogenic causation in 58-70% of familial cases of distal renal tubular acidosis. Recently, mutations in FOXI1 have been identified as an additional cause. Read More

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http://dx.doi.org/10.1016/j.kint.2019.09.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7039771PMC
March 2020
8.563 Impact Factor

A rare case of autosomal recessive ATP6V0A4 variant of distal renal tubular acidosis in a young female with recurrent nephrolithiasis.

Saudi J Kidney Dis Transpl 2019 Nov-Dec;30(6):1442-1446

Department of Nephrology, Madras Medical Mission Hospital, Mogappair, Chennai, Tamil Nadu, India.

Homozygous autosomal recessive distal renal tubular acidosis (dRTA) is a rare entity. The intercalated cells in the collecting ducts are defective in apical proton secretion or basolateral bicarbonate reabsorption, due to mutations in genes encoding for proteins in a4 and B1 subunits of the V-ATPase and the anion exchanger Cl/HCO (kAE1). This results in decreased ammonium (NH) excretion and defective urine acidification. Read More

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http://dx.doi.org/10.4103/1319-2442.275490DOI Listing
January 2020

Defective bicarbonate reabsorption in Kir4.2 potassium channel deficient mice impairs acid-base balance and ammonia excretion.

Kidney Int 2020 Feb 24;97(2):304-315. Epub 2019 Oct 24.

Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université Sorbonne Paris Cité (USPC), Université Paris Descartes, Université Paris Diderot, Paris, France; Centre National de la Recherche Scientifique (CNRS), ERL 8228, Paris, France. Electronic address:

The kidneys excrete the daily acid load mainly by generating and excreting ammonia but the underlying molecular mechanisms are not fully understood. Here we evaluated the role of the inwardly rectifying potassium channel subunit Kir4.2 (Kcnj15 gene product) in this process. Read More

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http://dx.doi.org/10.1016/j.kint.2019.09.028DOI Listing
February 2020

Clinical features, genetic background, and outcome in infants with urinary tract infection and type IV renal tubular acidosis.

Pediatr Res 2019 Dec 18. Epub 2019 Dec 18.

Division of Nephrology. Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Background: Type IV renal tubular acidosis (RTA) is a severe complication of urinary tract infection (UTI) in infants. A detailed clinical and molecular analysis is still lacking.

Methods: Infants with UTI who exhibited features of type IV RTA were prospectively enrolled. Read More

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http://dx.doi.org/10.1038/s41390-019-0727-7DOI Listing
December 2019

Urinary undiversion from a sigma-rectum pouch to a cutaneous urinary stoma as a treatment for severe metabolic disorders post-radical cystectomy: A case report.

Exp Ther Med 2019 Dec 21;18(6):4881-4887. Epub 2019 Oct 21.

Department of Urology, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu 210019, P.R. China.

A total of six male patients, who had undergone radical cystectomy and sigma-rectum pouch surgery due to bladder cancer (2-5 years previously), developed hyperchloremic metabolic acidosis, hypokalemia and renal dysfunction. The patients underwent urinary undiversion surgery (the pouch was isolated from the intestinal tract, abdominal ostomy was performed, and the sigmoid colon and rectum were reconnected) and blood gas and electrolyte analysis and renal function were compared pre- and post-surgery. Blood hydrocarbonate levels significantly improved 3 months post-surgery compared with the preoperative levels (17. Read More

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http://dx.doi.org/10.3892/etm.2019.8111DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880452PMC
December 2019

Assessment of Acute Kidney Injury in Neurologically Injured Patients Receiving Hypertonic Sodium Chloride: Does Chloride Load Matter?

Ann Pharmacother 2020 Jun 2;54(6):541-546. Epub 2019 Dec 2.

University of Alabama at Birmingham, Birmingham, AL, USA.

Increasing evidence suggests that large-volume infusions of 0.9% sodium chloride (NaCl) for resuscitation are associated with hyperchloremic metabolic acidosis, renal vasoconstriction, and increased risk of acute kidney injury (AKI). Patients with neurological injury may require hypertonic NaCl for therapeutic hypernatremia, treatment of cerebral salt wasting, hyponatremia, or elevated intracranial pressure. Read More

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http://dx.doi.org/10.1177/1060028019891986DOI Listing

Treatment of refractory and superrefractory status epilepticus with topiramate: A cohort study of 106 patients and a review of the literature.

Epilepsia 2019 12 11;60(12):2448-2458. Epub 2019 Nov 11.

Department of Neurology, Epilepsy Center Frankfurt Rhine-Main, Goethe University Frankfurt, Frankfurt am Main, Germany.

Objective: Novel treatments are needed to control treatment-resistant status epilepticus (SE). We present a summary of clinical cases where oral topiramate (TPM) was used in refractory SE (RSE) and superrefractory SE (SRSE).

Methods: A review of medical records was carried out to detect TPM administration in SE patients treated in Frankfurt and Marburg between 2011 and 2016. Read More

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http://dx.doi.org/10.1111/epi.16382DOI Listing
December 2019

Intravenous Fluid Prescription Practices in Critically Ill Children: A Shift in Focus from Natremia to Chloremia?

J Pediatr Intensive Care 2019 Dec 19;8(4):218-225. Epub 2019 Jun 19.

Department of Pediatrics (Critical Care), McMaster University, London, Ontario, Canada.

Our objective is to evaluate intravenous (IV) fluid prescription practice patterns in critically ill children in the first 72 hours of pediatric intensive care unit (PICU) admission and to evaluate the incidence and predictors of hyperchloremic metabolic acidemia (HCMA) and the association between HCMA and adverse outcomes. This retrospective cohort study was conducted in two tertiary-care Canadian PICUs. Children aged 0 to 18 years admitted to the PICU between January 2015 and January 2016 who received at least 50% of their calculated maintenance fluid requirements parenterally during the first 24 hours of admission were included. Read More

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http://dx.doi.org/10.1055/s-0039-1692413DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6821529PMC
December 2019
1 Read

A randomized, controlled, double-blind crossover study on the effects of isoeffective and isovolumetric intravenous crystalloid and gelatin on blood volume, and renal and cardiac hemodynamics.

Clin Nutr 2019 Oct 16. Epub 2019 Oct 16.

Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK; MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK. Electronic address:

Background & Aims: Blood volume expanding properties of colloids are superior to crystalloids. In addition to oncotic/osmotic properties, the electrolyte composition of infusions may have important effects on visceral perfusion, with infusions containing supraphysiological chloride causing hyperchloremic acidosis and decreased renal blood flow. In this non-inferiority study, a validated healthy human subject model was used to compare effects of colloid (4% succinylated gelatin) and crystalloid fluid regimens on blood volume, renal function, and cardiac output. Read More

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http://dx.doi.org/10.1016/j.clnu.2019.09.011DOI Listing
October 2019
1 Read

Outcome and complications in horses administered sterile or non-sterile fluids intravenously.

J Vet Intern Med 2019 Nov 14;33(6):2739-2745. Epub 2019 Oct 14.

Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan.

Background: Obtaining commercial fluids for intravenous administration (IVF) was challenging during a recent shortage. This necessitated use of custom-made non-sterile fluids for intravenous administration (JUGs) in some hospitals. There are no studies comparing outcome of horses treated with JUG versus IVF and limited information is available about adverse effects of JUGs. Read More

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http://dx.doi.org/10.1111/jvim.15631DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6872628PMC
November 2019
1 Read

Managing Chloride and Bicarbonate in the Prevention and Treatment of Acute Kidney Injury.

Semin Nephrol 2019 09;39(5):473-483

Adult Critical Care Unit, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom; William Harvey Research Institute, Queen Mary University of London, London, United Kingdom; Department of Renal Medicine and Transplantation, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom. Electronic address:

Intravenous crystalloid therapy is one of the most ubiquitous aspects of hospital and critical care medicine. In recent years, there has been increasing focus on the electrolyte composition, and particularly chloride content, of crystalloid solutions. This has led to increasing clinical adoption of balanced solutions, containing substrates for bicarbonate generation and consequently a lower chloride content, in place of 0. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S02709295193006
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http://dx.doi.org/10.1016/j.semnephrol.2019.06.007DOI Listing
September 2019
3 Reads

[Distal Renal Tubular Acidosis: Clinical Variability in the Same Family].

Acta Med Port 2019 Aug 1;32(7-8):542-545. Epub 2019 Aug 1.

Unidade de Nefrologia Pediátrica. Hospital Pediátrico de Coimbra. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Primary distal renal tubular acidosis is a genetic disorder characterized by the inability in acidification of urine. Symptoms are usually non-specific and highly variable. We described six cases in a family with four generations affected. Read More

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http://dx.doi.org/10.20344/amp.10758DOI Listing
August 2019
2 Reads

Normal Saline Versus Balanced Crystalloid Solutions for Kidney Transplantation.

Transplant Proc 2019 Sep 8;51(7):2262-2264. Epub 2019 Aug 8.

Anesthesiology and Reanimation Clinic, Dr. Lütfi Kirdar Training and Research Hospital, Istanbul, Turkey.

Introduction: The ideal crystalloid solution to be used during the perioperative period in patients undergoing kidney transplantation remains unclear. Normal saline (NS), the intravenous fluid commonly using during the perioperative period, contains a high chloride content, which may be associated with hyperchloremic metabolic acidosis and acute kidney injury. Balanced crystalloid (BC) solutions have a lower chloride content. Read More

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http://dx.doi.org/10.1016/j.transproceed.2019.03.050DOI Listing
September 2019
2 Reads

Impact of balanced versus unbalanced fluid resuscitation on clinical outcomes in critically ill children: protocol for a systematic review and meta-analysis.

Syst Rev 2019 08 5;8(1):195. Epub 2019 Aug 5.

Division of Critical Care, Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.

Background: Isotonic crystalloid fluid bolus therapy is used in critically ill children to restore or maintain hemodynamic stability. However, the ideal choice of crystalloid remains to be determined. The most easily available and most frequently used crystalloid is 0. Read More

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http://dx.doi.org/10.1186/s13643-019-1109-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683512PMC
August 2019
3 Reads

[Minimal change disease during lithium therapy: case report].

G Ital Nefrol 2019 Jul 24;36(4). Epub 2019 Jul 24.

UO Nefrologia e Dialisi, Ospedale Santa Maria delle Croci, Ravenna, Ausl Romagna.

Lithium is a largely used and effective therapy in the treatment of bipolar disorder. Its toxic effects on kidneys are mostly diabetes insipidus, hyperchloremic metabolic acidosis and tubulointerstitial nephritis. Also, a correlation between lithium and minimal change disease has sometimes been described. Read More

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July 2019
4 Reads

Hyperchloremic normal gap metabolic acidosis.

Minerva Endocrinol 2019 Dec 24;44(4):363-377. Epub 2019 Jul 24.

Department of Health Studies, College of Arts and Sciences, American University, Washington, DC, USA.

Metabolic acidosis is defined as a pathologic process that, when unopposed, increases the concentration of hydrogen ions (H+) in the body and reduces the bicarbonate (HCO3-) concentration. Metabolic acidosis can be of a kidney origin or an extrarenal cause. Assessment of urinary ammonium excretion by calculating the urine anion gap or osmolal gap is a useful method to distinguish between these two causes. Read More

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http://dx.doi.org/10.23736/S0391-1977.19.03059-1DOI Listing
December 2019
7 Reads

Effect of 3% saline and furosemide on biomarkers of kidney injury and renal tubular function and GFR in healthy subjects - a randomized controlled trial.

BMC Nephrol 2019 06 3;20(1):200. Epub 2019 Jun 3.

Holstebro Hospital, Hospital Unit West, Holstebro, Denmark.

Background: Chloride is speculated to have nephrotoxic properties. In healthy subjects we tested the hypothesis that acute chloride loading with 3% saline would induce kidney injury, which could be prevented with the loop-diuretic furosemide.

Methods: The study was designed as a randomized, placebo-controlled, crossover study. Read More

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http://dx.doi.org/10.1186/s12882-019-1342-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6545674PMC
June 2019
17 Reads

A case of entecavir-induced Fanconi syndrome.

CEN Case Rep 2019 11 1;8(4):256-260. Epub 2019 Jun 1.

Department IV, Internal Medicine, Tokyo Women's Medical University, 8-1, Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan.

Acquired Fanconi syndrome has been associated with the long-term ingestion of several nucleoside analogs used to treat chronic hepatitis B virus infection. However, the nucleoside analog entecavir has not been found to cause nephrotoxicity. We report a case of entecavir-induced Fanconi syndrome. Read More

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http://dx.doi.org/10.1007/s13730-019-00404-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820641PMC
November 2019
8 Reads

Clinical Impact of Saline Volume Infused Through Irrigated-Tip Ablation Catheter in Low Acuity Paroxysmal Atrial Fibrillation Ablation Patients.

J Atr Fibrillation 2018 Dec 31;11(4):2093. Epub 2018 Dec 31.

Section of Cardiac Electrophysiology, Department of Cardiology, OhioHealth Heart and Vascular Physicians, Riverside Methodist Hospital, 3535 Olentangy River Road, Columbus, OH 43214, USA.

Background: Radio-Frequency ablation (RFA) to achieve pulmonary vein isolation (PVI) remains mainstay therapy for symptomatic paroxysmal atrial fibrillation (PAF). The clinical consequences of large saline infusions during AF ablation have not been systematically studied. We utilized the differential flow-rates of the two commercially available ablation catheters (AC): 'ThermoCool' (TCAC) and 'Surround Flow' (SFAC) from Biosense-Webster to evaluate the clinical impact of the saline infused in the immediate post-ablation period. Read More

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http://dx.doi.org/10.4022/jafib.2093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6533834PMC
December 2018
6 Reads

Comparative evaluation of intraoperative use of normal saline, Ringer's lactate, and combination of normal saline and Ringer's lactate in neurosurgical patients - A preliminary randomized clinical trial.

Neurol India 2019 Mar-Apr;67(2):452-458

Department of Neuroanaesthesia, AIIMS, New Delhi, India.

Background: Fluid management during intracranial surgery is an important concern. The type of fluid used can have biochemical and metabolic effects during intraoperative management. However, it is yet to be known whether biochemical and metabolic effects have an influence on the clinical outcome of a patient. Read More

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http://dx.doi.org/10.4103/0028-3886.258047DOI Listing
July 2019
8 Reads
1.084 Impact Factor

[Distal hereditary renal tubular acidosis, diagnosis in siblings: About 2 pediatric cases].

Arch Argent Pediatr 2019 06;117(3):e263-e269

Unidad de Terapia Intermedia Pediátrica, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires.

Distal renal tubular acidosis is the most common type of renal tubular acidosis in pediatrics and can be hereditary. It is due to an inability in the kidney to excrete hydrogen ion (H+), in the absence of deterioration of renal function, and it is accompanied by hyperchloremic metabolic acidosis with normal anion gap. The symptoms can be growth retardation, vomiting, constipation, lack of appetite, polydipsia and polyuria, nephrocalcinosis, weakness and even muscle paralysis due to hypokalemia. Read More

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https://www.sap.org.ar/docs/publicaciones/archivosarg/2019/v
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http://dx.doi.org/10.5546/aap.2019.e263DOI Listing
June 2019
21 Reads

Balanced Electrolyte Solutions or Normal Saline? Resuscitative Fluid Administration Practice in Swiss Pediatric Acute Care: A Cross-Sectional Study.

Pediatr Emerg Care 2019 Apr 29. Epub 2019 Apr 29.

Pediatric Emergency Department, Inselspital, University Hospital, University of Bern, Bern, Switzerland.

Introduction: The ideal asanguineous intravenous fluid for volume resuscitation in children is controversially debated and clinical practice guidelines are scarce. Administration of large amounts of normal saline has been associated with complications including hyperchloremic acidosis, dysnatremia, neurologic damage, and fatality.

Aim: We examined the current practice of intravenous fluid and blood product administration in acutely ill and injured children among pediatric acute care physicians in Switzerland. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001813DOI Listing
April 2019
7 Reads

Acid-Base Disturbances in Patients with Asthma: A Literature Review and Comments on Their Pathophysiology.

J Clin Med 2019 Apr 25;8(4). Epub 2019 Apr 25.

Intensive Care Unit, 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 115 27 Athens, Greece.

Asthma is a common illness throughout the world that affects the respiratory system function, i.e., a system whose operational adequacy determines the respiratory gases exchange. Read More

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http://dx.doi.org/10.3390/jcm8040563DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6518237PMC
April 2019
13 Reads

Distal renal tubular acidosis and severe hypokalemia: a case report and review of the literature.

J Med Case Rep 2019 Apr 26;13(1):103. Epub 2019 Apr 26.

Nephrology Division, Department of Internal Medicine, St. Louis University, St. Louis, MO, USA.

Background: Distal renal tubular acidosis is a relatively infrequent condition with complex pathophysiology that can present with life-threatening electrolyte abnormalities.

Case Presentation: We describe a case of a 57-year-old Caucasian woman with previous episodes of hypokalemia, severe muscle weakness, and fatigue. Upon further questioning, symptoms of dry eye and dry mouth became evident. Read More

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http://dx.doi.org/10.1186/s13256-019-2056-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485144PMC
April 2019
9 Reads

Effect of Furosemide under Hyperchloremic Acidosis on Intraoperative Oliguria and Acute Kidney Injury in Patients with Normal Renal Function.

Nephron 2019 16;142(4):320-327. Epub 2019 Apr 16.

Department of Anesthesiology, Hamamatsu Rosai Hospital, Japan Organization of Occupational Health and Safety, Hamamatsu, Japan.

Background: Renal function tends to deteriorate in a hyperchloremic acidifying environment, which is reflected by a decrease in the difference between sodium and chloride.

Objectives: To examine the effect of furosemide administered under hyperchloremic acidosis on intraoperative oliguria and acute kidney injury in patients with preoperatively normal renal function.

Methods: In patients undergoing abdominal or orthopedic surgeries (April 2010-November 2018), we retrospectively identified patients who preoperatively had a normal renal function but experienced intraoperative oliguria under hyperchloremic acidosis (a sodium-chloride difference < 30 mEq/L) without dehydration. Read More

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http://dx.doi.org/10.1159/000499938DOI Listing
April 2019
7 Reads

Hyperchloremic metabolic acidosis in the kidney transplant patient.

Postgrad Med 2019 Apr 29;131(3):171-175. Epub 2019 Mar 29.

a Human Physiology Department , Instituto Universitario del Hospital Italiano de Buenos Aires , Buenos Aires , Argentina.

Hyperchloremic metabolic acidosis of renal origin results from a defect in renal tubular acidification mechanism, and this tubular dysfunction can consist of an altered tubular proton secretion or bicarbonate reabsorption capability. Studies have documented that all forms of renal tubular acidosis (RTA), type I to IV, are documented in kidney transplant patients. Among RTA pathophysiologic mechanisms have been described the renal mass reduction, hyperkalemia, hyperparathyroidism, graft rejection, immunologic diseases, and some drugs such as renin-angiotensin-aldosterone blockers, and calcineurin inhibitors. Read More

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http://dx.doi.org/10.1080/00325481.2019.1592360DOI Listing
April 2019
17 Reads

Hypotonic versus isotonic maintenance fluid administration in the pediatric surgical patient.

Semin Pediatr Surg 2019 Feb 23;28(1):43-46. Epub 2019 Jan 23.

University of Nebraska Medical Center, Children's Hospital and Medical Center, 8200 Dodge Street, 4th Floor Pavilion, Omaha, 68114 NE, United States. Electronic address:

Intravenous fluid administration has been occurring for well over one hundred years for a variety of pediatric disease processes. Surprisingly, clinicians have yet to agree upon a standardized intravenous solution. There is ongoing debate regarding the administration of isotonic versus hypotonic fluids as maintenance solutions. Read More

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http://dx.doi.org/10.1053/j.sempedsurg.2019.01.007DOI Listing
February 2019
6 Reads

Association of Perioperative Hyperchloremia and Hyperchloremic Metabolic Acidosis with Acute Kidney Injury After Craniotomy for Intracranial Hemorrhage.

World Neurosurg 2019 05 22;125:e1226-e1240. Epub 2019 Feb 22.

Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, South Korea. Electronic address:

Background: The present study evaluated the relationships among perioperative hyperchloremic metabolic acidosis (HCA), hyperchloremia, and postoperative acute kidney injury (AKI) in patients who had undergone craniotomy for intracranial hemorrhage (ICH).

Methods: The present retrospective cohort study included adult patients who had undergone craniotomy for traumatic or spontaneous ICH from January 2005 to December 2017. The association of perioperative hyperchloremia (serum chloride [Cl] >110 mmol/L during postoperative days 0-3), an increase in Cl levels (maximum Cl level in postoperative days 0-3 minus the baseline Cl level before surgery), and perioperative HCA (Cl >110 mmol/L; pH <7. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.02.015DOI Listing
May 2019
25 Reads
2.417 Impact Factor

Fluids and hyperosmolar agents in neurocritical care: an update.

Curr Opin Crit Care 2019 04;25(2):105-109

Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery Johns Hopkins School of Medicine, Baltimore Maryland. USA.

Purpose Of Review: To discuss recent updates in fluid management and use of hyperosmolar therapy in neurocritical care.

Recent Findings: Maintaining euvolemia with crystalloids seems to be the recommended fluid resuscitation for neurocritical care patients. Buffered crystalloids have been shown to reduce hyperchloremia in patients with subarachnoid hemorrhage without causing hyponatremia or hypo-osmolality. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000585DOI Listing
April 2019
15 Reads

Correlation of Hyperchloremic Metabolic Acidosis and Renal Function in Critically ill Patients of Emergency Department: an Observational Study.

Emerg (Tehran) 2018 25;6(1):e52. Epub 2018 Aug 25.

Department of Medical, Surgical, Neurological, Metabolic and Geriatrics Sciences, University of Campania "L. Vanvitelli", Italy.
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Introduction: Early detection is crucial for prompt management of acute kidney injury (AKI) patients in emergency department (ED). This study aimed to investigate the usefulness of hyperchloremic metabolic acidosis (HCMA) levels in this regard.

Methods: In this retrospective observational study, > 18 years old critically ill patients presenting to ED of Marcianise Hospital, Italy, were divided into non-AKI and AKI group according to KDIGO guideline. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289160PMC
August 2018
14 Reads

Novel compound heterozygous ATP6V1B1 mutations in a Chinese child patient with primary distal renal tubular acidosis: a case report.

BMC Nephrol 2018 12 17;19(1):364. Epub 2018 Dec 17.

Central Laboratory, The Affiliated Hospital of Qingdao University, 1677 Wutaishan Road, Qingdao, 266555, China.

Background: Distal renal tubular acidosis (dRTA) is a heterogeneous disorder characterized by normal anion gap metabolic acidosis. Autosomal recessive dRTA is usually caused by mutations occurring in ATP6V1B1 and ATP6V0A4 genes,encoding subunits B1 and a4 of apical H-ATPase, respectively. The heterogeneous clinical manifestations of dRTA have been described in different ethnic groups harboring distinct mutations. Read More

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http://dx.doi.org/10.1186/s12882-018-1173-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297984PMC
December 2018
8 Reads

Shock Etiologies and Fluid Management in Liver Failure.

Semin Respir Crit Care Med 2018 Oct 28;39(5):538-545. Epub 2018 Nov 28.

Saint Eloi ICU, Montpellier University Hospital, Montpellier, France.

Liver failure can occur in patients with or without underlying chronic liver disease (mainly cirrhosis) and is, respectively, termed acute on chronic liver failure or acute liver failure (ALF). In both cases, it is associated with marked systemic inflammation and profound hemodynamic disturbances, that is, increased cardiac output, peripheral vasodilation, and decreased systemic vascular resistance, on top of several superimposed etiologies of shock. In patients with cirrhosis, sepsis is the main cause of intensive care unit admission but portal hypertension-related gastrointestinal hemorrhage is also common. Read More

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http://dx.doi.org/10.1055/s-0038-1672139DOI Listing
October 2018
10 Reads

Physico-chemical stability of Plasma-Lyte 148® and Plasma-Lyte 148® + 5% Glucose with eight common intravenous medications.

Paediatr Anaesth 2019 Feb 8;29(2):186-192. Epub 2019 Jan 8.

School of Medicine, University of Nottingham, Nottingham, UK.

Background: Plasma-Lyte 148® is a balanced, crystalloid intravenous (IV) fluid which is both calcium-free and isotonic. It prevents the hyperchloremic metabolic acidosis and iatrogenic hyponatremia seen with use of 0.9% sodium chloride and hypotonic solutions, respectively. Read More

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http://dx.doi.org/10.1111/pan.13554DOI Listing
February 2019
14 Reads

Renal Tubular Acidosis.

Pediatr Clin North Am 2019 02;66(1):135-157

Division of Nephrology, Department of Pediatrics, The Montreal Children's Hospital, McGill University Health Centre, Room B RC.6651, Montreal, Quebec H4A 3J1, Canada; Al Jalila Children's Hospital, Al Jadaf PO Box 7662, Dubai, UAE. Electronic address:

Renal tubular acidosis should be suspected in poorly thriving young children with hyperchloremic and hypokalemic normal anion gap metabolic acidosis, with/without syndromic features. Further workup is needed to determine the type of renal tubular acidosis and the presumed etiopathogenesis, which informs treatment choices and prognosis. The risk of nephrolithiasis and calcinosis is linked to the presence (proximal renal tubular acidosis, negligible stone risk) or absence (distal renal tubular acidosis, high stone risk) of urine citrate excretion. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00313955183013
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http://dx.doi.org/10.1016/j.pcl.2018.08.011DOI Listing
February 2019
58 Reads
2.198 Impact Factor

Balanced Crystalloid Solutions.

Am J Respir Crit Care Med 2019 04;199(8):952-960

2 The Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.

Intravenous fluid therapy is the most common intervention received by acutely ill patients. Historically, saline (0.9% sodium chloride) has been the most frequently administered intravenous fluid, especially in North America. Read More

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https://www.atsjournals.org/doi/10.1164/rccm.201809-1677CI
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http://dx.doi.org/10.1164/rccm.201809-1677CIDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6467313PMC
April 2019
14 Reads

A prospective, randomized, comparison study on effect of perioperative use of chloride liberal intravenous fluids versus chloride restricted intravenous fluids on postoperative acute kidney injury in patients undergoing off-pump coronary artery bypass grafting surgeries.

Ann Card Anaesth 2018 Oct-Dec;21(4):413-418

Department of Anaesthesia, Sri Siddhartha Medical College, Tumakur, Karnataka, India.

Context And Aims: Off-pump coronary artery bypass graft (OPCABG) is a form of CABG surgery. It is performed without the use of cardiopulmonary bypass machine as a surgical treatment for coronary heart disease. Acute kidney injury (AKI) is one of the common postoperative complications of OPCABG. Read More

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http://dx.doi.org/10.4103/aca.ACA_230_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206797PMC
April 2019
29 Reads

Initial Fluid Therapy in Pediatric Diabetic Ketoacidosis: A comparison of Hypertonic Saline Solution and Normal Saline Solution.

Pediatr Endocrinol Diabetes Metab 2018 ;24(2):56-64

Division of Pediatric Intensive Care, Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi - 110001, India.

Introduction: The optimal fluid therapy in children with DKA is a matter of debate, especially if we take into account its association with cerebral edema, the most important complication. Hypertonic Saline Solution is used in the treatment of cerebral edema, and also has been used for volume resuscitation in children with shock.

Aim Of Study: To compare the effects of 3% saline and 0. Read More

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http://pediatricendocrinology.pl/?doi=10.18544/PEDM-24.02.01
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http://dx.doi.org/10.18544/PEDM-24.02.0103DOI Listing
December 2018
16 Reads

A Case of Cardiac Arrhythmia from Absorption of Normal Saline during Hysteroscopic Myomectomy.

J Minim Invasive Gynecol 2019 May - Jun;26(4):770-773. Epub 2018 Sep 27.

Department of Anesthesia (Dr. Brown), BC Women's Hospital, Vancouver, British Columbia, Canada; Department of Anesthesiology, Pharmacology and Therapeutics (Dr. Brown), University of British Columbia, Vancouver, British Columbia, Canada. Electronic address:

We present a case of severe hypokalemia, metabolic acidosis, and arrhythmia after absorption of 2500 mL normal saline during a hysteroscopic myomectomy. The patient was a 36-year-old woman with abnormal uterine bleeding caused by a submucosal leiomyoma. She received a total of 3500 mL normal saline (2500 mL was absorbed via the uterus and 1000 mL given intravenously) during hysteroscopy. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15534650183124
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http://dx.doi.org/10.1016/j.jmig.2018.09.778DOI Listing
August 2019
22 Reads

Play dough ingestion caused pronounced hyperchloremic acidosis in a toddler.

Clin Toxicol (Phila) 2019 01 27;57(1):64-65. Epub 2018 Sep 27.

a Swedish Poisons Information Centre , Stockholm , Sweden.

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https://www.tandfonline.com/doi/full/10.1080/15563650.2018.1
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http://dx.doi.org/10.1080/15563650.2018.1489963DOI Listing
January 2019
39 Reads

Comparison of normal saline and balanced crystalloid (plasmalyte) in patients undergoing elective craniotomy for supratentorial brain tumors: A randomized controlled trial.

Neurol India 2018 Sep-Oct;66(5):1338-1344

Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.

Background: The choice of fluid is important in neurosurgical patients, who may be dehydrated due to the administration of diuretics in order to reduce cerebral edema. Normal saline, the infused fluid routinely used in neurosurgical patients, can cause hyperchloremic metabolic acidosis. A balanced crystalloid (BC) may help to maintain the metabolic status more favorably in these patients, without adversely affecting brain relaxation. Read More

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http://dx.doi.org/10.4103/0028-3886.241347DOI Listing
September 2019
14 Reads

Acid base variables predict survival early in the course of treatment with continuous venovenous hemodiafiltration.

Medicine (Baltimore) 2018 Sep;97(36):e12221

Departamento de Doentes Graves-Hospital Israelita Albert Einstein-São Paulo.

Metabolic acid-base disorders, especially metabolic acidosis, are common in critically ill patients who require renal replacement therapy. Continuous veno-venous hemodiafiltration (CVVHDF) achieves profound changes in acid-base status, but metabolic acidosis can remain unchanged or even deteriorate in some patients. The objective of this study is to understand the changes of acid-base variables in critically ill patients with septic associated acute kidney injury (SA-AKI) during CVVHDF and to determine how they relate to clinical outcome. Read More

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http://dx.doi.org/10.1097/MD.0000000000012221DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6133476PMC
September 2018
29 Reads
5.723 Impact Factor

A mouse model of pseudohypoaldosteronism type II reveals a novel mechanism of renal tubular acidosis.

Kidney Int 2018 09 7;94(3):514-523. Epub 2018 Jul 7.

Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 970, Paris, France; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1188, CYROI, Sainte Clotilde, La Réunion, France; Centre National de la Recherche Scientifique, Délégation Paris Michel-Ange, Paris, France. Electronic address:

Pseudohypoaldosteronism type II (PHAII) is a genetic disease characterized by association of hyperkalemia, hyperchloremic metabolic acidosis, hypertension, low renin, and high sensitivity to thiazide diuretics. It is caused by mutations in the WNK1, WNK4, KLHL3 or CUL3 gene. There is strong evidence that excessive sodium chloride reabsorption by the sodium chloride cotransporter NCC in the distal convoluted tubule is involved. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00852538183035
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http://dx.doi.org/10.1016/j.kint.2018.05.001DOI Listing
September 2018
36 Reads

Pseudo-Renal Tubular Acidosis: Conditions Mimicking Renal Tubular Acidosis.

Adv Chronic Kidney Dis 2018 07;25(4):358-365

Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, MI; and Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI.

Hyperchloremic metabolic acidosis, particularly renal tubular acidosis, can pose diagnostic challenges. The laboratory phenotype of a low total carbon dioxide content, normal anion gap, and hyperchloremia may be misconstrued as hypobicarbonatemia from renal tubular acidosis. Several disorders can mimic renal tubular acidosis, and these must be appropriately diagnosed to prevent inadvertent and inappropriate application of alkali therapy. Read More

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http://dx.doi.org/10.1053/j.ackd.2018.05.001DOI Listing
July 2018
14 Reads