High dietary protein imposes a metabolic acid load requiring excretion and buffering by the kidney. Impaired acid excretion in CKD, with potential metabolic acidosis, may contribute to the progression of CKD. Here, we investigated the renal adaptive response of acid excretory pathways in mice to high-protein diets containing normal or low amounts of acid-producing sulfur amino acids (SAA) and e...

THE effectiveness of ehlorothiazide and related compounds as diuretics and antihypertensive agents has been well established. Much confusion still exists, however, regarding the exact mechanisms by which these ag,ents reduce arterial pressure. Although it has not been fully established whether the reduction in arterial pressure following the thiazides is due solely to sodium diuresis,1 is secon...

Paroxysmal nocturnal haemoglobinuria (PNH) also known as 'Marchiafava Micheli syndrome' is a rare condition which can lead to both acute and chronic forms of renal failure through renal tubular haemosiderin deposition. A 45-year-old lady with underlying PNH, presented with complaints of fever, productive cough followed by dark coloured urine. Investigations revealed pancytopenia with a markedly...

Intravenous infusion of norepinephrine is usually effective and safe to maintain adequate cerebral perfusion pressure for the management of posttraumatic intracranial hypertension. We report the case of a 17-year-old woman who suffered from traumatic intracranial bleeding and hypotension; she developed rhabdomyolysis, myoglobinuria and acute renal failure after receiving high dose norepinephrin...

The major electrolyte change for a man working and living at 5.34 to 5.80 km. was shown by Dill and coworkers (1) to be a decrease in bicarbonate and sodium content of the serum and some increase in its chloride content. It was demonstrated by Davies, Haldane, and Kennaway (2) and by Leathes (3) that forced breathing of air resulted in a diuresis of an alkaline urine. It was also shown (2) that...

ASPIRIN poisoning is responsible for over 200 deaths per annum in England and Wales. Forced alkaline diuresis is advocated to hasten renal elimination of the drug when plasma salicylate levels exceed 500 mg/l, whilst charcoal haemoperfusion is the treatment of choice when plasma salicylate levels exceed 900 mg/kg.' This severity of poisoning causes gross respiratory, metabolic and coagulation d...

Crush injuries resulting in traumatic rhabdomyolysis are an important cause of acute renal failure. Ischemia reperfusion is the main mechanism of muscle injury. Intravascular volume depletion and renal hypoperfusion, combined with myoglobinuria, result in renal dysfunction. The infusion of intravenous fluids before extrication or soon after injury may lessen the severity of the crush syndrome. ...