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The Kidney's Role in Homeostasis Chronic Kidney Damage, Medical and…

- - - - The kidney plays a metabolic role in the excretion of Bicarbonate
    - - FIRST FUNCTION
        
        Reabsorption of virtual all of the filtered Bicarbonate
        
        70-80% of bicarbonate is reabsorbed in the proximal tubule
        
        rest of bicarbonate is reabsorbed in the distal segments of the nephron
      - SECOND FUNCTION
        
        The kidneys product additional bicarbonate beyond that which has been filtered at the glomerulus
        
        This is accomplished by ammonia being excreted into the urine which results in new bicarbonate formation
  - - - This can lead to a faster progression of CKD and a higher incidence of death
      - What is Metabolic Acidosis?
        
        The cause of metabolic acidosis in CKD: impaired ammonia excretion, decreased tubular reabsorption of bicarbonate, and insufficient production of bicarbonate in relation to the amount of acids synthesized in the body and ingested with food
        
        Signs and Symptoms
        
        Hand tremor
        
        lightheadedness
        
        Confusion
        
        Muscle Twitching
        
        Nausea and Vomiting
        
        Numbness or tingling
        
        prolonged muscle spasms
        
        Hyperpnea (long deep breaths at a normal rate)
        
        Bicarbonate level less than 20mmol/L
        
        pH is below 7.20
        
        Glomerular filtration rate lower than 40-50 mL/min causes metabolic acidosis in CKD
        
        CLINICAL TREATMENT
        
        Dialysis Therapy
        
        Biicarbonate Therapy
        
        Bicarbonate therapy slows the progression of CKD
        
        sodium bicarbonate
        
        sodium citrate
        
        Diet Therapy
        
        fiber, fruits, and vegetables
- - - - link to www.picuki.com
- - - - One litre of fluid weighs 1kg, so your weight will go down by 1kg for every litre of excess fluid your body gets rid of.
        
        how do decrease you fluid intake
        
        You can reduce the amount of fluid you drink by:
        
        • using small cups or filling cups only half-full
        
        • taking small sips rather than big gulps
        
        • measuring your total fluid allowance into a jug at the start of each day. Every time you have a drink, take that amount of volume away from the jug, so that you know what you have left to drink.
        
        • letting family and friends know that you can only drink a certain amount each day, so that they are not tempted to give you extra fluids
        
        • spreading your allowance evenly throughout the day
        
        • sucking small ice cubes (an average ice cube is 10-20mls, so 10 ice cubes = a small cup)
        
        • having sweets such as mints, boiled sweets or chewing gum instead of a drink, or if your mouth feels dry.