Our Kidneys which are\nalso called the master chemist of the body maintains the electrolytic balance\nof the body fluid, maintains the osmolarity and acid \u2013 base balance.<\/p>\n\n\n\n
1.<\/strong>\nThe kidneys are the key organs to maintain the balance of the different\nelectrolytes in the body and the acid-base balance. In case of Kidney failure progressive\nloss of kidney function results in a number of adaptive and compensatory Renal\nand Extra-renal changes that allow homeostasis to be maintained with Glomerular\nfiltration rates in the range of 10-25 ml\/min. With Glomerular filtration rates\nbelow 10 ml\/min, there are almost always abnormalities in the body’s internal\nenvironment with clinical repercussions. <\/p>\n\n\n\n 2. Water Balance Disorders:<\/strong>\nIn advanced chronic kidney disease (CKD), the range of urine osmolarity\nprogressively approaches plasma osmolarity and becomes isostenuric. This\nmanifests clinically as symptoms of nocturia and polyuria, especially in tubulointerstitial\nkidney diseases. Water overload will result in hyponatremia and a decrease in\nwater intake will lead to hypernatremia. Routine analyses of serum Na levels is\nperformed in all patients with advanced CKD. Except in edematous states, a\ndaily fluid intake of 1-1.5 liters should be recommended. Hyponatremia does not\nusually occur with Glomerular filtration rates above 10 ml\/min. If it occurs,\nan excessive intake of free water should be considered or nonosmotic release of\nvasopressin by stimuli such as pain, anesthetics, hypoxemia or hypovolemia, or\nthe use of diuretics. Hypernatremia is less frequent than hyponatremia in CKD.<\/p>\n\n\n\n 3.\nSodium Balance Disorders:<\/strong> In CKD, fractional excretion of sodium increases\nso that absolute sodium excretion is not modified until Glomerular filtration\nrates below 15 ml\/min. Total body content of sodium is the main determinant of\nextracellular volume and therefore disturbances in sodium balance will lead to\nclinical situations of volume depletion or overload: Volume depletion due to\nrenal sodium loss occurs in abrupt restrictions of salt intake in advanced CKD.\nIt occurs more frequently in certain tubulointerstitial kidney diseases (salt\nlosing nephropathies). Volume overload due to sodium retention can occur with\nGlomerular filtration rates below 25 ml\/min and leads to edema, arterial\nhypertension and heart failure. The use of diuretics in volume overload in CKD\nis useful to force natriuresis. Weight and volume should be monitored regularly\nin the hospitalized patient with CKD. <\/p>\n\n\n\n 4. Potassium Balance Disorders:<\/strong>\nIn CKD, the ability of the kidneys to excrete potassium decreases\nproportionally to the loss of glomerular filtration. Stimulation of aldosterone\nand the increase in intestinal excretion of potassium are the main adaptive\nmechanisms to maintain potassium homeostasis until glomerular filtration rates\nof 10 ml\/min. The main causes of hyperkalemia in CKD are the following: Use of\ndrugs that alter the ability of the kidneys to excrete potassium: ACEIs, ARBs,\nNSAIDs, aldosterone antagonists, nonselective beta-blockers, heparin,\ntrimetoprim, calcineurin inhibitors. Determination of serum potassium two weeks\nafter the initiation of treatment with ACEIs\/ARBs is recommended. Routine use\nof aldosterone antagonists in advanced CKD is not recommended. A low-potassium\ndiet is recommended with GFR less than 20 ml\/min, or GFR less than 50 ml\/min if\ndrugs that raise serum potassium are taken. In the absence of symptoms or\nelectrocardiographic abnormalities, review of medications, restriction of\ndietary potassium and use of oral ion exchange resins are usually sufficient\ntherapeutic measures. Parenteral bicarbonate and ion exchange resins in enemas\nare not recommended as first-line treatment. Hemodialysis is considered in\npatients with glomerular filtration rates below 10 ml\/min.<\/p>\n\n\n\n 5. Acid-Base Disorders in CKD:<\/strong>\nModerate metabolic acidosis (Bic 16-20) mEq\/L is common with Glomerular\nfiltration rates below 20 ml\/min, and favors bone demineralization due to the\nrelease of calcium and phosphate from the bone, chronic hyperventilation, and\nmuscular weakness and atrophy. Its treatment consists of administration of\nsodium bicarbonate, usually orally (0.5-1 mEq\/kg\/day), with the goal of\nachieving a serum bicarbonate level of 22-24 mmol\/L. Limitation of daily\nprotein intake to less than 1 g\/kg\/day is also useful. Use of sevelamer as a\nphosphate binder aggravates metabolic acidosis since it favors endogenous acid\nproduction and therefore acidosis should be monitored and corrected if it occurs.\nHypocalcaemia should always be corrected before metabolic acidosis in CKD.\nMetabolic acidosis is an infrequent disorder and requires exogenous alkali\nadministration (bicarbonate, phosphate binders) or vomiting.<\/p>\n\n\n\n Homeopathic Aspect<\/strong><\/p>\n\n\n\n With\nthe help of Homeopathic medicines acid base balance along with Osmolarity can\nbe maintained. The electrolyte balance with symptoms can also be corrected with\nHomeopathic medicines, moreover the Homeopathic medicines if used in high\ndilutions (NANO Form) do not contain any crude drug material, hence are totally\nharmless with no side effects.\n<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":" Our Kidneys which are also called the master chemist of the body maintains the electrolytic balance of the body fluid, maintains the osmolarity and acid \u2013 base balance. 1. The kidneys are the key organs to maintain the balance of the different electrolytes in the…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"yst_prominent_words":[],"_links":{"self":[{"href":"https:\/\/www.kidneyfailed.in\/blog\/wp-json\/wp\/v2\/posts\/115"}],"collection":[{"href":"https:\/\/www.kidneyfailed.in\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.kidneyfailed.in\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.kidneyfailed.in\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.kidneyfailed.in\/blog\/wp-json\/wp\/v2\/comments?post=115"}],"version-history":[{"count":1,"href":"https:\/\/www.kidneyfailed.in\/blog\/wp-json\/wp\/v2\/posts\/115\/revisions"}],"predecessor-version":[{"id":116,"href":"https:\/\/www.kidneyfailed.in\/blog\/wp-json\/wp\/v2\/posts\/115\/revisions\/116"}],"wp:attachment":[{"href":"https:\/\/www.kidneyfailed.in\/blog\/wp-json\/wp\/v2\/media?parent=115"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.kidneyfailed.in\/blog\/wp-json\/wp\/v2\/categories?post=115"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.kidneyfailed.in\/blog\/wp-json\/wp\/v2\/tags?post=115"},{"taxonomy":"yst_prominent_words","embeddable":true,"href":"https:\/\/www.kidneyfailed.in\/blog\/wp-json\/wp\/v2\/yst_prominent_words?post=115"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}