Nephron: Overview, Tubular Transport and Tubular Secretion

by Carlo Raj, MD

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    Our discussion earlier was dealing with bicarb. Talked about the physio of it all. Let us give some clinical correlations like you should be doing in every step of the way. Normally what this we are talking about lowering the renal threshold for bicarb. What does that even mean? That means that you actually not reabsorbing bicarb. Listen to what I just said. We are going to lower our standard terminology, the renal threshold for reclaiming bicarb, which means what? That means more the bicarb remains within the urine and you are going to get rid of it. So, therefore, your normal bicarb level, which is between 22 to 26 and we are using 24 has now dropped down to 15 where, please? In the plasma right. Now you tell me acid-base disturbances from physiology. If you want to drop your bicarb down to 15, what does that mean to you? Acidosis because you don't have as much bicarb. You have lost it. What kind of acidosis? Is this respiratory acidosis or would this be metabolic acidosis? Good. Metabolic acidosis. Are you clear? If you have metabolic acidosis let me take one step further just to make sure we are good here. If you have metabolic acidosis and how you are going to compensate, you are going to try to blow off your carbon dioxide very quickly so therefore within minutes, you are going to start hyperventilating so that you can blow off that carbon dioxide, aren't you? Continue. So now this results with what? Loss of more of the filtered bicarb than the normal renal threshold. Why might you want to do this as a method of compensation? As a method of compensation maybe perhaps you are doing this remember that high altitude patient that we talked about acutely...

    About the Lecture

    The lecture Nephron: Overview, Tubular Transport and Tubular Secretion by Carlo Raj, MD is from the course Diseases of the Nephron. It contains the following chapters:

    • Proximal vs. Distal Nephron
    • Tubular Transport by Nephron Segment
    • Tubular Secretion

    Author of lecture Nephron: Overview, Tubular Transport and Tubular Secretion

     Carlo Raj, MD

    Carlo Raj, MD

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