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Fractional Excretion of Bicarbonate

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1. Fractional Excretion of Bicarbonate

Fractional Excretion of Bicarbonate Fractional Excretion of Bicarbonate Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fractional (...) Excretion of Bicarbonate Fractional Excretion of Bicarbonate Aka: Fractional Excretion of Bicarbonate , FE-HCO3 II. Indications Differentiate from Requires that serum bicarbonate be normal III. Calculation FE-HCO3 = (uHCO3 x sCr) / (sHCO3 x uCr) Annotation Where FE-HCO3 is Fractional Excretion of Bicarbonate Where uHCO3 is urine bicarbonate Where sHCO3 is serum bicarbonate Where uCr is Where sCr is IV. Interpretation FE-HCO3 <5%: FE-HCO3 >15%: Assumes serum bicarbonate >20 meq/L Images: Related links

2018 FP Notebook

2. Fractional Excretion of Sodium (FENa): Diagnostic Godsend or Gimmick?

with volume [4, 5]; both of which my patient has! When volume contraction is the result of gastric loss of hydrogen chloride (HCl), a metabolic alkalosis ensues. The kidneys compensate by excreting sodium bicarbonate; consequently, distal delivery of sodium is increased and the FENa quotient will also elevate. One mechanism by which the kidneys increase bicarbonate excretion is via the [6]. In clinical scenarios where loss of chloride is prominent (e.g. loss of gastric contents), a low fractional (...) Fractional Excretion of Sodium (FENa): Diagnostic Godsend or Gimmick? Fractional Excretion of Sodium (FENa): Diagnostic Godsend or Gimmick? – Clinical Correlations Search Fractional Excretion of Sodium (FENa): Diagnostic Godsend or Gimmick? September 5, 2012 7 min read By Jon-Emile S Kenny, MD Faculty Peer Reviwed A 62- year-old man with a history of hypertension, diastolic dysfunction and chronic kidney disease is admitted 4 days after beginning outpatient treatment of community acquired

2012 Clinical Correlations

3. Fractional Excretion of Bicarbonate

Fractional Excretion of Bicarbonate Fractional Excretion of Bicarbonate Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fractional (...) Excretion of Bicarbonate Fractional Excretion of Bicarbonate Aka: Fractional Excretion of Bicarbonate , FE-HCO3 II. Indications Differentiate from Requires that serum bicarbonate be normal III. Calculation FE-HCO3 = (uHCO3 x sCr) / (sHCO3 x uCr) Annotation Where FE-HCO3 is Fractional Excretion of Bicarbonate Where uHCO3 is urine bicarbonate Where sHCO3 is serum bicarbonate Where uCr is Where sCr is IV. Interpretation FE-HCO3 <5%: FE-HCO3 >15%: Assumes serum bicarbonate >20 meq/L Images: Related links

2015 FP Notebook

4. The Efficiency and Safety of Sodium Bicarbonate on Uric Acid in Patients With Asymptomatic Hyperuricemia or Gout

No Intervention: No Intervention Outcome Measures Go to Primary Outcome Measures : Serum uric acid [ Time Frame: 1 month after randomization ] Change from baseline serum levels of uric acid at 1 month Secondary Outcome Measures : Fraction excretion of uric acid [ Time Frame: 1 month after randomization ] Change from baseline fraction excretion of uric acid at 1 month Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal (...) The Efficiency and Safety of Sodium Bicarbonate on Uric Acid in Patients With Asymptomatic Hyperuricemia or Gout The Efficiency and Safety of Sodium Bicarbonate on Uric Acid in Patients With Asymptomatic Hyperuricemia or Gout - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved

2017 Clinical Trials

5. The BASE Study: Bicarbonate Administration to Stabilize Estimated Glomerular Filtration Rate (eGFR)

will examine the percentage of participants in each dose arm who are prescribed (i) the full randomized sodium bicarbonate dose according to the protocol at the end of 28 weeks and (ii) at least 25% of the randomized sodium bicarbonate dose according to the protocol at the end of 28 weeks. The two doses of sodium bicarbonate being tested are 0.5 and 0.8 mEq/kg-lean body weight per day. Secondary Outcome Measures : Change in Urinary ammonium excretion in mEq/L from baseline to 28 weeks. [ Time Frame (...) : Baseline, 28 weeks ] Sodium bicarbonate reduces urinary ammonium excretion (mEq/L). This outcome will determine if the 0.8 mEq/kg-lean body weight per day dose lowers urinary ammonium excretion more than the 0.5 mEq/kg-lean body weight per day dose. Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about

2015 Clinical Trials

6. Effects of Volume Expansion, Purified Parathyroid Extract, and Calcium on Renal Bicarbonate Absorption in the Dog Full Text available with Trip Pro

filtration rate (GFR) and filtered HCO(3) (-) did not change. Both groups showed a significant increase in the fractional excretion of sodium (C(Na) x 100/GFR), calcium (C(Ca) x 100/GFR), and chloride (C(Cl) x 100/GFR) and a decrease in phosphorus reabsorption. Fractional clearance of phosphate (C(P) x 100/GFR) rose in both groups but did not achieve significance. Infusion of purified parathyroid extract (PTE) decreased RHCO(3) in intact dogs (from 24.6 to 22.5 mmol/liter GFR, P < 0.025) and in TPTX dogs (...) (from 26.9 to 22.6 mmol/liter GFR, P < 0.05). No change was noted in GFR, renal blood flow (RBF), filtered HCO(3) (-), or fractional excretion of sodium, calcium, or chloride in either group. There was a significant increase in fractional phosphorus clearance and a decrease in phosphorus reabsorption in each group. Infusion of Ca(++) raised ultrafilterable Ca(++) from 5.7 to 7.9 mg/100 ml in intact and from 4.9 to 7.2 mg/100 ml in TPTX dogs; RHCO(3) increased in intact (from 22.9 to 26.9 mmol/liter

1974 Journal of Clinical Investigation

7. On the mechanisms responsible for the phosphaturia of bicarbonate administration. Full Text available with Trip Pro

On the mechanisms responsible for the phosphaturia of bicarbonate administration. Experiments were carried out in normal dogs to characterize the mechanisms by which sodium bicarbonate administration results in increased excretion of phosphate. Infusion of sodium bicarbonate alone increased fractional phosphate excretion from 0.8 to 29.3%. During bicarbonate administration, ionized calcium fell and mean parathyroid hormone values increased from 59.6 to 230.4 muleq/ml. In the same group of dogs (...) , administration of sodium bicarbonate plus calcium prevented the fall in ionized calcium, and parathyroid hormone levels remained unchanged. In these dogs fractional phosphate excretion increased from 2.4 to only 4.9%. Similar results were obtained in thyroparathyroidectomized dogs receiving sodium bicarbonate. In these dogs fractional excretion of phosphate increased from 0.6 to 4.5%. Under all three experimental conditions no differences were observed in sodium or bicarbonate excretion or in urinary

1975 Journal of Clinical Investigation

8. Regulation of renal bicarbonate reabsorption by extracellular volume Full Text available with Trip Pro

and isotonic saline, isotonic saline alone (two of the animals in this group received HCl to lower the plasma bicarbonate concentration), and isotonic bicarbonate. The results were similar in each group. Extracellular volume expansion depressed bicarbonate reabsorption. This depression was related not to changes in glomerular filtration rate (GFR) or bicarbonate concentration, but to the increase of fractional sodium excretion. In addition, volume expansion with bicarbonate increased chloride excretion (...) Regulation of renal bicarbonate reabsorption by extracellular volume The ability of the kidney to reabsorb bicarbonate is held to be a function of plasma CO(2) tension, carbonic anhydrase activity, and potassium stores. The effects of alterations of extracellular volume on bicarbonate reabsorption were studied in dogs whose arterial Pco(2) was kept constant at 40 mm Hg (range 35-45 mm Hg). The effect of extracellular volume expansion was studied in dogs receiving hypertonic bicarbonate

1970 Journal of Clinical Investigation

9. Renal Tubular Acidosis in Infants: the Several Kinds, Including Bicarbonate-Wasting, Classic Renal Tubular Acidosis Full Text available with Trip Pro

RTA (type 1 RTA) in the following ways. (a) The fractional excretion of filtered bicarbonate (C(HCO3)/C(ln)) was not trivial but substantial (6-9%), as well as relatively fixed, over a broad range of plasma bicarbonate concentrations (15-26 mmoles/liter). (b) This value of C(HCO3)/C(ln), combined with a normal or near normal glomerular filtration rate, translated to renal bicarbonate wasting (RBW). (c) RBW at normal plasma bicarbonate concentrations was the major cause of acidosis, and its (...) classic RTA and "alkali-resistant" acidosis but rarely in adult patients with classic RTA. Continued supplements of potassium were required to maintain normokalemia during sustained correction of acidosis with alkali therapy. Yet, in at least two of the three infants with apparently classic RTA, but in distinction from the patient with FS and other patients with type 2 RTA, fractional excretion of filtered potassium decreased when plasma bicarbonate was experimentally increased to normal values

1972 Journal of Clinical Investigation

10. The phosphaturic effect of sodium bicarbonate and acetazolamide in dogs Full Text available with Trip Pro

The phosphaturic effect of sodium bicarbonate and acetazolamide in dogs Urinary inorganic phosphate excretion was studied before and during the administration of sodium bicarbonate and acetazolamide in dogs that were not given infusions of phosphate. The excretion fraction of filtered phosphate increased after sodium bicarbonate or acetazolamide was given. This phosphaturia was attributed to decreased tubular reabsorption of phosphate consequent to alkalinization of either tubular urine

1968 Journal of Clinical Investigation

11. Sodium zirconium cyclosilicate (Lokelma) - For the treatment of hyperkalaemia (HK) in adult patients.

Product availability date April 2019 Summary of evidence on comparative efficacy Sodium zirconium cyclosilicate is an orally administered non-polymer inorganic cation exchange crystalline compound. It is not absorbed from the gastro-intestinal tract where it captures potassium cations in exchange for hydrogen and sodium cations, thereby reducing the amount of absorbable free potassium, increasing faecal excretion of potassium and decreasing serum potassium. 1,2 It is licensed for treatment (...) that current management of patients in the proposed positioning would be to withhold RAASi. Other 6 interventions used include dietary potassium restriction advice, treatment of metabolic acidosis with oral bicarbonate and addition of diuretics. Across the sodium zirconium cyclosilicate studies the primary outcomes differed, although they all assessed serum potassium levels. For sodium zirconium cyclosilicate 10g three times daily (the licensed dose for the correction phase), evidence was available from

2020 Scottish Medicines Consortium

12. Sodium zirconium cyclosilicate (Lokelma) - treatment of hyperkalaemia in adult patients

of evidence on comparative efficacy Sodium zirconium cyclosilicate is an orally administered non-polymer inorganic cation exchange crystalline compound. It is not absorbed from the gastro-intestinal tract where it captures potassium cations in exchange for hydrogen and sodium cations, thereby reducing the amount of absorbable free potassium, increasing faecal excretion of potassium and decreasing serum potassium. 1,2 It is licensed for treatment of hyperkalaemia (high serum potassium) in adults 1 (...) . The submitting company proposed that it be positioned for use in adults with hyperkalaemia (defined as serum potassium =5.5 or =6.0 mmol/L depending on clinical context) who would otherwise need to down-titrate or discontinue their renin-angiotensin-aldosterone system inhibitor (RAASi) to maintain an acceptable serum potassium level (normokalaemia), and who have chronic kidney disease (CKD) stage 3b to 5 and/or heart failure (ejection fraction 5.5 mmol/L, with mild elevations defined as 5.5 to 5.9 mmol/L

2020 Scottish Medicines Consortium

14. Management of Cardiovascular Diseases during Pregnancy Full Text available with Trip Pro

Calcium channel blocker CI Confidence interval CO Cardiac output CoA Coarctation of the aorta CPG Committee for Practice Guidelines CT Computed tomography CVD Cardiovascular disease DBP Diastolic blood pressure DCM Dilated cardiomyopathy DES Drug-eluting stent DVT Deep vein/venous thrombosis ECG Electrocardiogram EF Ejection fraction ESC European Society of Cardiology FDA US Food and Drug Administration HCM Hypertrophic cardiomyopathy HF Heart failure HFrEF Heart failure with reduced ejection fraction (...) 5-HT1A 5-hydroxytryptamine (serotonin) HTAD Heritable thoracic aortic disease ICD Implantable cardioverter-defibrillator ICU Intensive care unit IE Infective endocarditis INR International normalized ratio i.v. Intravenous KLH Keyhole limpet haemocyanin LMWH Low molecular weight heparin LQTS Long QT syndrome LV Left ventricular LVEF Left ventricular ejection fraction MCS Mechanical circulatory support mGy Milligray MI Myocardial infarction MR Mitral regurgitation MRA Mineralocorticoid receptor

2018 European Society of Cardiology

15. Sodium zirconium cyclosilicate (Lokelma) - Hyperkalemia

and faecal concentrations of calcium and magnesium. The serum concentrations of all these electrolytes remained unchanged. In the GLP toxicity studies in dogs, oral administration of sodium zirconium cyclosilicate also decreased the urinary fractional excretion of potassium (FE-K) in a dose dependent manner by 85-95% and significantly reduced the serum potassium concentration at the highest doses when administered at 1000 mg/kg/tid for 28 days or at 2000 mg/kg/day for 9 months. These dosages, equivalent (...) act in an analogous manner to the selectivity filter utilized by physiologic potassium channels. The exchange with potassium ions occurs throughout the gastrointestinal tract with onset in the upper part of the gastrointestinal tract. The trapped potassium ions are excreted from the body via the faeces, thereby reducing any excess and resolving hyperkalaemia. As claimed by the applicant, ZS demonstrates improved capacity, selectivity, and speed for entrapping excess potassium over currently

2018 European Medicines Agency - EPARs

17. Pediatric Post–Cardiac Arrest Care: A Scientific Statement From the American Heart Association

. Pediatric post–cardiac arrest studies evaluating myocardial dysfunction are limited. In small retrospective studies of pediatric OHCA, elevations in troponin I and decreased ventricular shortening fraction and ejection fraction are associated with increased mortality. In a retrospective study of 58 children within 24 hours of admission after ROSC from OHCA, transthoracic echocardiograms demonstrated decreased left ventricular systolic function in 41%, which was associated with increased mortality. Left (...) , possibly hours after ROSC, may not reflect the impact of excessive oxygen administration in the minutes to early hours after ROSC. After ROSC, it is reasonable to aim for normal Pa o 2 (or the value appropriate for the child’s condition if the child has, for example, cyanotic heart disease) and to use the lowest possible fraction of inspired oxygen, weaning to maintain an oxygen saturation of 94% to 99% as a guideline. Throughout PCAC, hypoxemia must be avoided whenever possible, particularly during

2019 American Heart Association

18. Renal tubular acidosis

immunoglobulins interstitial nephritis hyperparathyroidism Thai or southeast Asian ancestry outdated tetracycline cis-platinum therapy toluene, paraquat, lysol exposure Balkan heritage Dent's disease ibuprofen overdose lamivudine antiviral therapy (cidofovir, adefovir, or tenofovir) Diagnostic investigations serum bicarbonate serum chloride serum sodium serum potassium arterial blood pH serum anion gap urine pH serum aldosterone urine anion gap measurement of fractional bicarbonate excretion urine PCO2 (...) bicarbonate infusion furosemide test ammonium chloride loading test furosemide and fludrocortisone test urine glucose tubular maximum (Tm) reabsorption of phosphate fractional excretion of amino acids ultrasound CT/spiral CT nuclear renal scan Treatment algorithm ONGOING Contributors Authors Professor Emeritus Texas Tech University Health Sciences Center Lubbock TX Disclosures MEL declares that he has no competing interests. Dr Melvin E. Laski would like to gratefully acknowledge Dr Elizabeth Cobb, Dr

2017 BMJ Best Practice

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