Article
Transplantation
Garabed Eknoyan
Summary: The conceptual evolution of acid-base homeostasis has been greatly influenced by progress in chemistry. The development started with theoretical considerations by ancient natural philosophers and gradually evolved into established scientific concepts in modern chemistry. These advancements have significantly contributed to the clinical recognition, interpretation, and treatment of acid-base disorders.
NEPHROLOGY DIALYSIS TRANSPLANTATION
(2022)
Article
Urology & Nephrology
Takuya Fujimaru, Takuya Shuo, Masahiko Nagahama, Fumika Taki, Masaaki Nakayama, Yasuhiro Komatsu
Summary: This study assessed the relationship between urine osmolal gap (UOG) and urinary ammonium (U-NH4+) in patients with chronic kidney disease (CKD). It was found that UOG could be a useful tool in clinical settings, especially in patients with moderate to severe CKD. The estimated U-NH4+ using UOG was consistently higher than the measured values, suggesting a potential benefit of using this method for assessing renal acid excretion in CKD patients.
Article
Urology & Nephrology
Hendrik W. Zijlstra, Coen A. Stegeman
Summary: The increase of Anion Gap in patients with chronic kidney disease (CKD) is limited and less pronounced than the decrease in HCO3-. The severity of CKD and the magnitude of the Anion Gap should be taken into account when evaluating metabolic acidosis.
CLINICAL KIDNEY JOURNAL
(2023)
Article
Urology & Nephrology
Jaime Uribarri, David S. Goldfarb, Kalani L. Raphael, Joshua L. Rein, John R. Asplin
Summary: Ammonium is an important parameter in urine that can provide important clues about the causes of metabolic acidosis. The urinary anion gap (UAG) is not a good predictor of UNH4, and measuring UNH4 is important in clinical nephrology.
AMERICAN JOURNAL OF KIDNEY DISEASES
(2022)
Review
Biochemistry & Molecular Biology
Seong-Ki Lee, Walter F. Boron, Rossana Occhipinti
Summary: Carbonic anhydrases (CAs) are essential for physiological processes due to their role in catalyzing the conversion of CO2 and water to bicarbonate and protons, impacting pH levels. In the kidneys, CAs and HCO3- transporters, specifically the NCBTs and AEs, play significant roles in urinary acid secretion, particularly HCO3- reabsorption. Recent findings suggest that NCBTs transport CO32- instead of HCO3-, suggesting a revised understanding of their function. This review examines the role of CAs and HCO3- transporters in renal acid-base physiology and discusses the implications of novel findings on HCO3- reabsorption.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Engineering, Environmental
Biplab K. Mahata, Kun-Lin Chung, Sue-min Chang
Summary: The Cu-loaded amino-functionalized SiO2 and weak-base-anion-exchange resin demonstrated advanced adsorption capability for NH4+ removal, with the adsorption process involving endothermic deprotonation and exothermic complexation. The adsorption ability increased with higher initial pH values, and coexistence of certain chloride-based salts promoted NH4+ adsorption. The adsorbent could be successfully recovered with 0.15 M NaCl solution, preserving high adsorption ability over multiple recovery cycles.
CHEMICAL ENGINEERING JOURNAL
(2021)
Article
Pediatrics
Farahnak Assadi
Summary: Measuring urine anion gap can help differentiate between chronic respiratory alkalosis and metabolic acidosis, especially when arterial blood gas is not available.
PEDIATRIC PULMONOLOGY
(2023)
Article
Pharmacology & Pharmacy
Andrew K. Posen, Frank P. Paloucek, Renee Petzel
Summary: The anion gap is a critical parameter in identifying and monitoring acid-base disturbances, with a popular correction formula recently introduced to improve diagnostic yield. However, clinical trials show no benefit from applying this correction formula, and understanding the limitations of the original anion gap is important for diagnosing and trending acid-base disturbances.
AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY
(2022)
Review
Critical Care Medicine
Sarah F. Sanghavi, Erik R. Swenson
Summary: Disorders of acid-base status are common in critically ill patients and their prompt recognition is crucial. The bicarbonate/carbon dioxide buffer system is vital for maintaining acid-base homeostasis and measurements of pH, PCO(2), and HCO(3)(-) are routinely used to assess the severity of metabolic and respiratory disturbances. Hypoventilation and hyperventilation lead to primary respiratory acidosis and alkalosis, respectively. Metabolic acidosis and alkalosis can have various causes, including changes in acid or base intake, fluid losses, abnormalities in metabolism, and dysfunction in the kidneys, liver, or gastrointestinal system. The concept of anion gap is used to categorize metabolic acidosis, while urine chloride excretion helps define metabolic alkalosis. The lungs and kidneys employ compensatory mechanisms to minimize pH changes caused by physiological and disease disturbances. Treatment of acid-base disorders should focus on correcting the underlying cause and addressing the associated hemodynamic and electrolyte imbalances. In certain conditions, specific therapies such as renal replacement therapy, mechanical ventilation, respiratory stimulants or depressants, and inhibition of specific enzymes may be considered.
SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Article
Pharmacology & Pharmacy
J. Shen, D-L Li, Z-S Yang, Y-Z Zhang, Z-Y Li
Summary: This study investigated whether anion gap (AG) can be used as a potential predictive biomarker for the recovery of neurological and cognitive functions in patients with intracerebral hemorrhage (ICH). The study found that AG levels measured at admission were significantly associated with the 180-day outcomes of the patients. Additionally, interventions to rectify AG levels promoted the recovery of neurological and cognitive functions.
EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES
(2022)
Article
Medicine, General & Internal
Chang Yin Chionh, Cheng Boon Poh, Debajyoti M. Roy, Sreekanth Koduri, Bing Lun Chow, Pei Ting Tan, Aung Soe Tin, Jia Wen Kam, Chin Shern Lau, See Ping Hoo, Soon Kieng Phua, Tar Choon Aw
Summary: This study aimed to determine the reference interval for anion gap (AG) based on current laboratory techniques. Through blood analysis of 284 participants in a health screening, the normal reference interval for AG was found to be 10-18 mmol/L. Differences in AG were detected for sex, race, obesity, and serum albumin, but the differences were minimal.
INTERNAL MEDICINE JOURNAL
(2022)
Article
Medicine, Research & Experimental
Emma Kuusela, Mikko J. Jarvisalo, Tapio Hellman, Panu Uusalo
Summary: This study compares the initial clinical course and 90-day mortality in adults with methanol or ethylene glycol poisoning treated with dialysis. The results show that patients with ethylene glycol poisoning are older and have lower urine output after dialysis initiation. The mortality rate is associated with metabolic acidosis, a large anion gap, and altered mental status on admission.
JOURNAL OF INTERNATIONAL MEDICAL RESEARCH
(2022)
Article
Urology & Nephrology
Anand Achanti, Harold M. Szerlip
Summary: Acid-base disorders are common in the intensive care unit and can be categorized into metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis. A systematic approach to diagnosis and appropriate treatment is essential for managing these disorders effectively.
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
(2023)
Article
Urology & Nephrology
Nimrit Goraya, Nicolaos E. Madias, Abdullah Mamun, Jan Simoni, Donald E. Wesson
Summary: In patients with chronic kidney disease, covert acid stress is associated with disease progression. This study found that urinary citrate (UcitV) can better identify dietary acid load, while ammonium (UNH4+V) can better indicate H+ retention. However, further research is needed to establish a clinically useful diagnostic method.
AMERICAN JOURNAL OF NEPHROLOGY
(2023)
Article
Medicine, General & Internal
Michal Terlecki, Maryla Kocowska-Trytko, Krzysztof Plens, Tomasz Drozdz, Christopher Pavlinec, Krystian Gruszka, Lukasz Klima, Wiktoria Wojciechowska, Jerzy Wordliczek, Katarzyna Stolarz-Skrzypek, Marek Rajzer
Summary: This study aimed to confirm the relationship between PVA-BP on admission and the outcome in MI patients treated with PCI. The evaluation of PVA-BP in POCT analyzers may be a reliable tool for early risk stratification in patients admitted to the ED with MI treated with PCI.
POLISH ARCHIVES OF INTERNAL MEDICINE-POLSKIE ARCHIWUM MEDYCYNY WEWNETRZNEJ
(2022)
Article
Biochemistry & Molecular Biology
Allein Plain, Wanling Pan, Deborah O'Neill, Megan Ure, Megan R. Beggs, Maikel Farhan, Henrik Dimke, Emmanuelle Cordat, R. Todd Alexander
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2020)
Article
Pediatrics
Marihan Lansing, George Slim, Pamela Wizzard, Mahroukh Rafii, Paul B. Pencharz, Patrick N. Nation, Megan R. Beggs, R. Todd Alexander, Paul W. Wales, Justine M. Turner, Ron O. Ball
Summary: This study examined the effects of 75% intestinal resection on whole-body arginine synthesis in piglets and found adaptive changes in intestinal arginine synthesis that may help preserve overall arginine synthesis in neonates. The intestine plays a crucial role in arginine synthesis, particularly in neonates at risk for short bowel syndrome.
PEDIATRIC RESEARCH
(2021)
Editorial Material
Neurosciences
R. Todd Alexander
JOURNAL OF PHYSIOLOGY-LONDON
(2021)
Article
Pediatrics
Anjali Mohapatra, Anna T. Valson, Vellaichamy M. Annapandian, Vinoi George David, Suceena Alexander, Shibu Jacob, Shailesh Kakde, Santosh Kumar, Antony Devasia, Theophilus S. Vijayakumar, Veerasamy Tamilarasi, Chakko Korula Jacob, Gopal Basu, George Tharayil John, Santosh Varughese
Summary: PAKT in India shows excellent long-term graft outcomes, but patient outcomes are still suboptimal due to a high burden of infections. Current immunosuppression protocols need to be re-examined to balance infection risk, graft, and patient survival.
PEDIATRIC TRANSPLANTATION
(2021)
Review
Immunology
Kelly A. Cairns, Victoria Hall, Genevieve E. Martin, David W. J. Griffin, James D. Stewart, Sadid F. Khan, Iain J. Abbott, Zaal Meher-Homji, Catherine O. Morrissey, Christopher Sia, Jane Love, Carmela E. Corallo, Peter Bergin, Ashish Sharma, Gopal Basu, Andrew Spencer, Anton Y. Peleg
Summary: Infections caused by carbapenemase-producing Enterobacteriaceae (CPE) pose a emerging threat in transplant recipients, often resulting in high mortality due to limited treatment options and toxicities. A novel approach using a combination of ceftazidime/avibactam with aztreonam has shown promise in successfully treating invasive MBL-CPE infections, offering a new treatment option with reduced drug interactions and toxicity for high-risk patients.
TRANSPLANT INFECTIOUS DISEASE
(2021)
Article
Urology & Nephrology
Riyaz Ahmed Asad, Anna T. Valson, Vijayakumar Kavitha, Anila Korula, Anu Eapen, Grace Rebekah, Shibu Jacob, Harish Pathak, Suceena Alexander, Anjali Mohapatra, Vinoi George David, Santosh Varughese, Veerasamy Tamilarasi, Gopal Basu
Summary: Kidney biopsy (KBx) is relatively safe in patients with severe kidney disease, but the risk to benefit balance needs to be carefully considered when eGFR is <15 ml/min/1.73m(2).
Review
Pediatrics
Mallory L. Downie, R. Todd Alexander
Summary: Most calcium filtered by the glomerulus is reabsorbed along the nephron through distinct cellular and paracellular pathways regulated by specific genes, with mutations in some of these genes leading to hypercalciuria. Understanding these molecular pathways can help in developing dietary and medical interventions to reduce urinary calcium excretion.
PEDIATRIC NEPHROLOGY
(2022)
Article
Medicine, General & Internal
David W. J. Griffin, Sakhee Kotecha, Gopal Basu, Paul Gow, Jillian S. Y. Lau, Catherine O. Morrissey, Jennifer F. Hoy
Summary: The incidence of end-stage organ disease in people living with HIV is increasing and the experience of solid organ transplantation in this population remains limited. This retrospective study aimed to review the outcomes of transplant in people living with HIV in Australia. The results showed that these patients achieved good clinical and functional outcomes after transplantation, but multidisciplinary planning and care are essential for optimizing their care.
INTERNAL MEDICINE JOURNAL
(2022)
Article
Transplantation
Darren Lee, Indra Gramnea, Nina Seng, Meaghan Bruns, Fiona Hudson, Rohit D'Costa, Leanne McEvoy, Joe Sasadeusz, Michael J. O'Leary, Gopal Basu, Joshua Y. Kausman, Rosemary Masterson, Kathy Paizis, John Kanellis, Peter D. Hughes, David J. Goodman, John B. Whitlam
Summary: Following the implementation of a new opt-in allocation pathway in Victoria, Australia, the utilization rate of IVRD kidneys significantly increased, with no active infections detected in recipients. IVRD kidneys exhibited superior quality and graft function compared to non-IVRD kidneys, despite the presence of increased risk behaviors.
TRANSPLANTATION DIRECT
(2021)
Editorial Material
Urology & Nephrology
Rolando Claure-Del Granado, Urmila Anandh, Edgar Lerma, Arvind Conjeevaram, Fernanda Arce-Amare, Augusto Cesar Soares dos Santos Jr, Gopal Basu, Sibel Bek, Ajaya Kumar Dhakal, Mohammed Abdel Gawad, Ahmed Akl, Didem Turgut, Sabine Karam, Divya Bajpai, Roberto Pecoits-Filho, Namrata Parikh
KIDNEY INTERNATIONAL REPORTS
(2022)
Letter
Medicine, General & Internal
Chi Xu, Vincent Wong, Ariefandi Kurniawan, Scott Wilson, Basu Gopal, Paul D. D. Lawton
INTERNAL MEDICINE JOURNAL
(2023)
Article
Endocrinology & Metabolism
Isabelle Rousseau-Nepton, Glenville Jones, Karlpiet Schlingmann, Martin Kaufmann, Caroline S. Zuijdwijk, Karine Khatchadourian, Indra R. Gupta, Daniele Pacaud, Maury N. Pinsk, Arati Mokashi, Munier A. Nour, R. Todd Alexander, Celia J. Rodd
Summary: Pathogenic variants in CYP24A1 in Canadian children manifest as late-onset hypercalciuria and related diseases. The 25-OH-D-3:24,25-(OH)(2)D-3 ratio is an excellent tool for screening biallelic pathogenic variants in CYP24A1. Cascade testing is important for these variants to identify affected family members.
HORMONE RESEARCH IN PAEDIATRICS
(2021)
Review
Transplantation
Gopal Basu, Sanjeev Nair, Sibel Gokcay Bek, Prashant Dheerendra, Krishnam Raju Penmatsa, Karthikeyan Balasubramanian, Aakash Shingada, Arvind Conjeevaram
Summary: Utilizing social media platforms to promote organ donation is seen as a key approach in raising awareness and addressing the issue of organ shortage. However, it is important to be aware of challenges such as maintaining confidentiality, the potential for misuse, misinformation, and negative framing.
INDIAN JOURNAL OF TRANSPLANTATION
(2021)
Article
Physiology
Patricia G. Ferreira, Wouter H. van Megen, Rebecca Tan, Christy H. L. Lee, Per Svenningsen, R. Todd Alexander, Henrik Dimke
Summary: This study investigated the role of Mg2+ in regulating urinary excretion of Ca2+ and Mg2+ through the Ca2+-sensing receptor-claudin 14 (CLDN14) pathway using transgenic models and in vitro assays. The results suggest that CLDN14 is unlikely to play a significant role in the compensatory response to hypermagnesemia.
AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY
(2021)
Article
Physiology
Sebastian Frische, R. Todd Alexander, Patricia Ferreira, Rebecca Siu Ga Tan, Weidong Wang, Per Svenningsen, Karsten Skjodt, Henrik Dimke
Summary: CLDN14 has a restricted localization pattern in the apical domain of select cells of the TAL, mainly co-expressed with CLDN16.
AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY
(2021)
Article
Pediatrics
Rebecca R. Seltzer, Simone Thompson
PEDIATRIC CLINICS OF NORTH AMERICA
(2024)
Article
Pediatrics
Kimberly E. Sawyer, Douglas J. Opel
PEDIATRIC CLINICS OF NORTH AMERICA
(2024)
Article
Pediatrics
Micah Hester, Skye A. Miner
Summary: The process of soliciting a minor's assent has moral importance, even if it is not always required by regulations. It allows the child's opinion to be heard and respects their development and involvement in research. The extent of the child's involvement depends on their age, experience, and maturity.
PEDIATRIC CLINICS OF NORTH AMERICA
(2024)
Article
Pediatrics
Nicholas A. Jabre, Margaret R. Moon
PEDIATRIC CLINICS OF NORTH AMERICA
(2024)
Article
Pediatrics
Carrie M. Henderson, Renee D. Boss
Summary: An increasing number of children with serious/complex illness are living with long-term prognostic uncertainty, intensive interactions with medical systems, functional limitations, and the use of chronic medical technologies that affect their quality of life. These families often face multiple medical decision points and rely on intentional and iterative discussions to guide their care goals.
PEDIATRIC CLINICS OF NORTH AMERICA
(2024)
Article
Pediatrics
Margaret R. Moon
PEDIATRIC CLINICS OF NORTH AMERICA
(2024)
Article
Pediatrics
Mark T. Hughes
PEDIATRIC CLINICS OF NORTH AMERICA
(2024)
