- Clinical Approach to Proximal Renal Tubular Acidosis in Children. [Review]
- ACAdv Chronic Kidney Dis 2018; 25(4):351-357
- Proximal renal tubular acidosis (pRTA) is an inherited or acquired clinical syndrome in which there is a decreased bicarbonate reclamation in the proximal tubule resulting in normal anion gap hyperch...
Proximal renal tubular acidosis (pRTA) is an inherited or acquired clinical syndrome in which there is a decreased bicarbonate reclamation in the proximal tubule resulting in normal anion gap hyperchloremic metabolic acidosis. In children, pRTA may be isolated but is often associated with a general proximal tubular dysfunction known as Fanconi syndrome which frequently heralds an underlying systemic disorder from which it arises. When accompanied by Fanconi syndrome, pRTA is characterized by additional renal wasting of phosphate, glucose, uric acid, and amino acids. The most common cause of inherited Fanconi syndrome in the pediatric age group is cystinosis, a disease with therapeutic implications. In this article, we summarize the clinical presentation and differential diagnosis of pRTA and Fanconi syndrome and provide a practical approach to their evaluation in children.
- Hypokalemic Distal Renal Tubular Acidosis. [Review]
- ACAdv Chronic Kidney Dis 2018; 25(4):303-320
- Distal renal tubular acidosis (DRTA) is defined as hyperchloremic, non-anion gap metabolic acidosis with impaired urinary acid excretion in the presence of a normal or moderately reduced glomerular f...
Distal renal tubular acidosis (DRTA) is defined as hyperchloremic, non-anion gap metabolic acidosis with impaired urinary acid excretion in the presence of a normal or moderately reduced glomerular filtration rate. Failure in urinary acid excretion results from reduced H+ secretion by intercalated cells in the distal nephron. This results in decreased excretion of NH4+ and other acids collectively referred as titratable acids while urine pH is typically above 5.5 in the face of systemic acidosis. The clinical phenotype in patients with DRTA is characterized by stunted growth with bone abnormalities in children as well as nephrocalcinosis and nephrolithiasis that develop as the consequence of hypercalciuria, hypocitraturia, and relatively alkaline urine. Hypokalemia is a striking finding that accounts for muscle weakness and requires continued treatment together with alkali-based therapies. This review will focus on the mechanisms responsible for impaired acid excretion and urinary potassium wastage, the clinical features, and diagnostic approaches of hypokalemic DRTA, both inherited and acquired.
- Alterations in Metabolic Status and Headshaking Behavior Following Intravenous Administration of Hypertonic Solutions in Horses with Trigeminal-Mediated Headshaking. [Journal Article]
- AAnimals (Basel) 2018 Jun 25; 8(7)
- Trigeminal-nerve-mediated headshaking represents a major welfare challenge for owners and veterinarians and is caused by a low threshold firing of the trigeminal nerve resulting in pain manifested as...
Trigeminal-nerve-mediated headshaking represents a major welfare challenge for owners and veterinarians and is caused by a low threshold firing of the trigeminal nerve resulting in pain manifested as violent head jerking that often terminates the horse’s career and life due to poor quality of life and suffering. As metabolic changes such as acid⁻base status and electrolytes play a role in nerve firing, this study sought to assess the effects following administration of hypertonic solutions on headshaking behavior in affected horses. This prospective randomized controlled crossover design utilized six horses affected with trigeminal-mediated headshaking and three treatment groups receiving intravenous administration of 5% dextrose solution at 2 mL/kg bwt (DS), NaCl 7.5% at 4 mL/kg bwt (HS), or NaHCO₃ 8.4% at 2 mmol/kg bwt (HB). Horses were assessed for headshaking behavior changes at times T0 (baseline, before infusion) and T15, 30, 60, 120 min post infusion. Venous blood variables: pH, HCO₃−, standard base excess (SBE), Na⁺, Cl−, K⁺, Ca2+, Mg2+, total magnesium (tMg), glucose, and lactate were measured at T0 (baseline, before infusion) and T5, 15, 30, 60, 120 min post infusion. Strong ion difference (SID) and anion gap (AG) were calculated for each time point. With HB treatment, there was greater than 50% reduction in headshaking rate. There was an effect of time on increasing headshaking rate. There was an effect of breed on headshaking rate. Changes in blood parameters following DS were virtually absent. Infusion of HS caused mild changes and did not vary much from baseline except for SID and AG. Only infusion of HB caused blood pH and HCO₃− to be outside of the physiologic range (alkalemia and metabolic alkalosis, respectively), SBE to double or triple, AG to decrease, and SID to increase compared to baseline. Infusion of DS was followed by increase in blood glucose and decrease in blood Na⁺. Infusion of HS was followed by increase in Na⁺ and Cl− and decrease in Mg2+. Infusion of HB was followed by decrease in Mg2+. Blood tMg, K⁺, and Ca2+ decreased slightly, but did not vary greatly from baseline following any of the treatments, remaining within physiologic ranges. Changes in blood composition were transient. Among all treatments, only HB had an effect on headshaking rate. The limited effects following these fluids were likely due to normal mechanisms of regulation of blood levels of pH and electrolytes. Further investigations of changes in electrolytes that might affect nerve firing should be explored.
- Photosynthetic and antioxidant response of wheat to di(2-ethylhexyl) phthalate (DEHP) contamination in the soil. [Journal Article]
- CChemosphere 2018; 209:258-267
- Di(2-ethylhexyl) phthalate (DEHP) is a commonly used, artificially-synthesized, industrial chemical that can be released into the soil. However, to date, there is no comprehensive study on the effect...
Di(2-ethylhexyl) phthalate (DEHP) is a commonly used, artificially-synthesized, industrial chemical that can be released into the soil. However, to date, there is no comprehensive study on the effects of DEHP on photosynthesis, induction of reactive oxygen species, and response of the antioxidant defense system in wheat plants growing in DEHP contaminated soil. This study was conducted to address this gap in knowledge. Our results showed that after application of 10, 20, and 40 mg/kg DEHP, photosynthetic parameters, fluorescence parameters, and chlorophyll content of wheat leaves at seedling, jointing, and booting stages decreased, while the intercellular carbon dioxide concentration increased. This indicates that the observed decrease in net photosynthetic rate in wheat leaves was due to a non-stomatal limitation, wherein DEHP seems to have hindered the photoelectron transfer process. Both superoxide anion (O2-) and hydrogen peroxide (H2O2) content increased in the roots, stems, and leaves in plant under DEHP treatment compared with those in the control plants. Antioxidant enzyme activity increased with increasing DEHP stress, except under the 40 mg/kg treatment at the seedling stage. The antioxidant system had a certain protective effect on wheat, but DEHP still caused peroxidation of cell membrane lipids. The extent of DEHP damage to the roots, stems, and leaves was concentration dependent. Furthermore, enzymatic activity tolerance increased with metabolism, and long-term effects of DEHP gradually decreased with plant growth. Finally, the toxic effects of DEHP on root tissues were more serious at the seedling and jointing stages.
- Effects of 12-Week Low or Moderate Dietary Acid Intake on Acid-Base Status and Kidney Function at Rest and during Submaximal Cycling. [Journal Article]
- NNutrients 2018 Mar 08; 10(3)
- Prolonged effects of dietary acid intake on acid-base status and kidney function have not yet been studied in an intervention study in healthy subjects. Dietary acid load can be estimated by calculat...
Prolonged effects of dietary acid intake on acid-base status and kidney function have not yet been studied in an intervention study in healthy subjects. Dietary acid load can be estimated by calculating the potential renal acid load (PRAL) of foods. Effects of low-PRAL and moderate-PRAL diets on acid-base status and kidney function were investigated during a 12-week exercise training period. Healthy, 20-50-year-old men (n = 21) and women (n = 25) participated in the study and were randomly divided into low-PRAL and moderate-PRAL groups. Before (PRE), mid-phase (MID) and after the intervention (POST), the subjects participated in measurement sessions, where a 12-h urine sample and fasting blood samples were collected, and a submaximal cycle ergometer test was performed. Net acid excretion was significantly lower after 12 weeks of the low-PRAL diet as compared to the moderate-PRAL diet, both in men and women. In low-PRAL females, capillary pH and bicarbonate were significantly higher at 75% of VO2max at POST as compared to PRE. Glomerular filtration rate decreased over the study period in moderate-PRAL men and women. The results of the present study suggest that an acidogenic diet and regularly training together may increase the acidic load of the body and start to impair the kidney function in recreationally active subjects.
- AGE-RELATED CHANGES IN HEMATOLOGY AND BLOOD BIOCHEMISTRY VALUES IN ENDANGERED, WILD RING-TAILED LEMURS (LEMUR CATTA) AT THE BEZÀ MAHAFALY SPECIAL RESERVE, MADAGASCAR. [Journal Article]
- JZJ Zoo Wildl Med 2018; 49(1):30-47
- The health of 44 wild ring-tailed lemurs (Lemur catta) at the Bezà Mahafaly Special Reserve was assessed across three age classes: <5 yr (young), 5-9 yr (adult), and ≥10 yr (old). Hematology and bioc...
The health of 44 wild ring-tailed lemurs (Lemur catta) at the Bezà Mahafaly Special Reserve was assessed across three age classes: <5 yr (young), 5-9 yr (adult), and ≥10 yr (old). Hematology and biochemistry tests were performed manually (leukocyte count and differential, packed cell volume, total protein) and using a point-of-care analyzer (hematocrit, hemoglobin, glucose, blood urea nitrogen, creatinine, sodium, potassium, chloride, ionized calcium, total carbon dioxide, anion gap), respectively. Urine specific gravity was measured via refractometry. Age- and sex-related differences were detected. Old lemurs had significantly lower lymphocyte count than adult and young lemurs, leading to markedly lower total leukocyte count and higher neutrophil-to-lymphocyte ratio. Decreased lymphocyte count with advanced age is consistent with immunosenescence. Young lemurs had significantly higher total protein, monocyte count, and potassium than adult and old lemurs but significantly lower ionized calcium than adult lemurs. Males had significantly higher leukocyte, neutrophil, and monocyte counts; lower percentage basophils; and higher blood urea nitrogen than females. Females had markedly higher glucose than males. Young females had the highest monocyte count and total protein, which were significantly lower in the adult and old age classes. Basophil count was stable in females across age but dropped precipitously in males in the adult and old age classes. Within adult and old age classes, males had significantly higher blood urea nitrogen and lower basophils than females. Glucose was significantly higher after α2 agonist administration. Identifying age-related hematologic and biochemical changes in apparently healthy wild ring-tailed lemurs will aid in clinical diagnosis and treatment of lemurs in human care, which is especially relevant for management of geriatric animals in zoo populations. Equally important, a better understanding of the ability of aging lemurs to tolerate environmental stressors will inform the capacity for this species to cope with ongoing and future habitat alteration.
- Comparison of acid-base and electrolyte changes following administration of 6% hydroxyethyl starch 130/0.42 in a saline and a polyionic solution in anaesthetized dogs. [Journal Article]
- VAVet Anaesth Analg 2018; 45(3):260-268
- CONCLUSIONS: Changes in both groups were minor and short-lived with either fluid in healthy individuals, but might become clinically relevant with higher fluid doses or in critically ill dogs.
- Radiosensitization by Liposome-Encapsulated Fullerenes to Mitochondria/DNA-Damages on Human Melanoma Cells. [Journal Article]
- JNJ Nanosci Nanotechnol 2018 Jun 01; 18(6):3775-3786
- The polyhydroxy small-gap fullerenes [C120O30(OH)30 · 30H2O · 25Na+: SGFs] were encapsulated in multilamellar liposomes (Lpsm) composed of 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) and 1,2-diol...
The polyhydroxy small-gap fullerenes [C120O30(OH)30 · 30H2O · 25Na+: SGFs] were encapsulated in multilamellar liposomes (Lpsm) composed of 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) and 1,2-dioleoyl-sn-glycero-3-phospho-l-serine (DOPS), which are designated as LpsmSGFs (DOPC/DOPS/SGFs = 35 mM:15 mM:246-445 μM, diameter = 141.2 nm, ζ-potential = -35.65 mV). Radiosensitization by LpsmSGFs under X-ray irradiation was evaluated on human melanoma HMV-II cells. On 7th day after X-ray irradiation, cell proliferation degree assessed by WST-8 decreased more markedly on cells pretreated with LpsmSGFs than Lpsm or free-SGFs. Fluorescent imaging of cells with Rhodamine123, dihydroethidium or anti-8-hydroxydeoxyguanosine antibody was monitored as an indicator for mitochondrial membrane potentials, intracellular superoxide anion radicals (O˙-2) or oxidative DNA-damages, respectively. After X-ray irradiation, LpsmSGFs obviously exhibited more augmented mitochondrial membrane potentials on perinuclear region of cells than Lpsm or free-SGFs. Without X-ray irradiation, superoxide anion radicals were found principally in the cytoplasm, but, when exposed to X-ray, they were found in cell nuclei associated with oxidative DNA-damages on cells pretreated with LpsmSGFs. Meanwhile, the oxidation-reduction potentials of SGFs aqueous solution increased by X-ray irradiation. These results suggest that LpsmSGFs-mediated generation of reactive oxygen species results in damages to cellular components such as mitochondria and DNA on cells, and thereby cell proliferation decreased. The LpsmSGFs has a potential as a pro-oxidative type radiosensitizer.
- Predictors of acute gastrointestinal bleeding in diabetic ketoacidosis: a retrospective observational study in minority population. [Journal Article]
- GRGastroenterol Rep (Oxf) 2017; 5(4):293-297
- CONCLUSIONS: We conclude that higher initial serum blood glucose was associated with increased incidence of AGIB in patients admitted with DKA. We also noted increased in-patient mortality in patients with DKA who had AGIB, even though statistically insignificant. More aggressive measures to correct blood glucose levels may result in decreased incidence of AGIB, thereby reducing mortality during hospitalization in patients with DKA.
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- Age-dependent physiological dynamics in acid-base balance, electrolytes, and blood metabolites in growing goats. [Journal Article]
- VJVet J 2017; 229:45-52
- There is a paucity of published data reporting acid-base equilibrium in goats, and no information is available on how the acid-base complexity changes when suckling goat kids become ruminants. The ai...
There is a paucity of published data reporting acid-base equilibrium in goats, and no information is available on how the acid-base complexity changes when suckling goat kids become ruminants. The aims of this study were to evaluate young healthy goats for age-related changes in serum proteins, metabolites, and electrolytes; differences in results when the Henderson-Hasselbalch equation or strong ion approaches were used were also assessed. To assess biological variability and reproducibility, two consecutive long-term studies, each lasting from the 6th to 56th week of life (wl), were performed in 15 (Study 1) and 10 (Study 2) animals. Blood gas analysis, serum biochemical analysis, and electrophoresis were performed on venous blood, and acid-base information was obtained using the traditional Henderson-Hasselbalch approach, Stewart's strong ion model, and Constable's simplified strong ion model. In all goats within the first 4-5 months, serum concentrations of glucose, l-lactate, and inorganic phosphate decreased significantly, while serum concentrations of total protein, albumin, and gamma globulin increased. Consequently, nonvolatile weak acids (Atot Alb and Atot TP) increased. At the end of this 'adaptation period', i.e. when milk was replaced by purely plant-based food, significantly lower bicarbonate and base excess values were accompanied by blood pH that shifted towards acidosis. Electrolytes (Na+, K+, Ca2+, and Cl-), anion gap, strong ion difference, and strong ion gap did not show age-dependent trends. In conclusion, somatic growth and development of gastro-intestinal fermentation in growing goats act as complex sources of physiological variability on acid-base equilibrium that was not reflected by the Henderson-Hasselbalch equation only.