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Intravenous sodium bicarbonate is indicated in the treatment of metabolic acidosis, such as can occur in severe kidney disease, diabetic ketoacidosis [citation needed], circulatory insufficiency, extracorporeal circulation of blood, in hemolysis requiring alkalinization of the urine to avoid nephrotoxicity of blood pigments, and certain drug intoxications, such as by barbiturate overdose ...
The mainstay of treatment is large quantities of intravenous fluids. [3] Other treatments may include dialysis or hemofiltration in more severe cases. [4] [10] Once urine output is established, sodium bicarbonate and mannitol are commonly used but they are poorly supported by the evidence. [3] [4] Outcomes are generally good if treated early. [3]
In the standard 3x/week hemodialysis schedule a URR of 65% is considered the minimum acceptable dose, corresponding to a minimum Kt/V of 1.2 [3] When dialysis is given more frequently than three times a week, the minimum acceptable URR is lower; because more dialysis treatments are given over the week, the dose of dialysis for each treatment ...
Hemodialysis, also spelled haemodialysis, or simply dialysis, is a process of filtering the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure.
Thiazide (blockade of sodium-chloride symporter), amiloride (blockade of epithelial sodium channels) and carbonic anhydrase inhibitors (blockade of chloride-bicarbonate exchanger pendrin) has been suggested to complement the action of loop diuretics in resistance cases but limited evidence are available to support their use.
All people with a GFR <60 mL/min/1.73 m 2 for 3 months are defined as having chronic kidney disease. [59] Protein in the urine is an independent marker for the worsening of kidney function and cardiovascular disease. Hence, British guidelines append the letter "P" to the stage of chronic kidney disease if protein loss is significant. [60]
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