Download PDF by Kar Neng Lai: A Practical Manual of Renal Medicine: Nephrology, Dialysis

By Kar Neng Lai

ISBN-10: 9812838716

ISBN-13: 9789812838711

This handbook offers useful and obtainable info on all elements of common nephrology, dialysis, and transplantation. It outlines present remedies in simple language to assist readers comprehend the remedy reason, and doesn't think vast wisdom of anatomy, biochemistry, or pathophysiology. which include 33 chapters written via 31 specialists from 4 continents, this quantity covers the entire functional counsel within the emergency and long term administration of sufferers with electrolyte disturbance, acid-base disturbance, acute renal failure, universal glomerular ailments, high blood pressure, pregnancy-related renal issues, power renal failure, and renal substitute treatment. it really is therefore a vital resource of fast reference for nephrologists, internists, renal fellows, and renal nursing experts, and can be compatible for graduate scholars and study scientists within the box of kidney ailments.

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Additional info for A Practical Manual of Renal Medicine: Nephrology, Dialysis and Transplantation

Sample text

1 Simple Acid-Base Disturbances An acid is a proton or hydrogen donor; and a base, a proton or hydrogen acceptor. For example, lactic acid = lactate− + H+. Lactic acid is an acid because it can donate H+, whereas lactate is a base because it can accept H+. 45. Normal arterial PCO2 = 40 ± 4 (± 2 SDa) mmHg, and normal arterial serum [HCO3−] = 25 ± 1 (± 2 SD) mmol/L (Note: […] refers to concentrations). 45. Acidosis is a process generating excess acid, while alkalosis is a process generating excess base.

Qxd 24 6/2/2009 3:01 PM Page 24 O. F. Kohn and T. S. g. acetazolamide, zonisamide, topiramate, topical mefanide acetate. (ii) Decreased acid excretion • Distal renal tubular acidosis (a) Genetic: gene mutations in the H+ ATPase or Cl−/HCO3− exchanger. (b) Acquired: often associated with hypergammaglobulinemia (Sjogren’s syndrome, HIV, systemic lupus erythematosus), amphotericin B. • Type 4 renal tubular acidosis (hyperkalemia with reduced NH4+ excretion). g. secondary to nonsteroidal anti-inflammatory agents), ACE inhibitors, HIV, spironolactone, heparin, cyclosporine or tacrolimus.

Kohn and T. S. 2 Expected adaptive response to a primary acid-base disturbance. e. e. 7. 2 Mixed Acid-Base Disturbances A mixed disorder is present when there is less than or more than the expected degree of adaptation. 4, [HCO3−] 24 mmol/L, PCO2 40 mmHg). • ⇓ pH, ⇓ [HCO3−], therefore metabolic acidosis. 2 mmHg ⇓ in PCO2 for each 1 mmol/L ⇓ in [HCO3−] (adaptation starts within 1 hour and complete by 12–24 hours). Expected respiratory adaptation is calculated as follows: [HCO3−] drop = 24 – 15 = 9 mmol/L.

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A Practical Manual of Renal Medicine: Nephrology, Dialysis and Transplantation by Kar Neng Lai


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