thank you. what i really want to know is what is the mechanism for hyperchloremia. in rta. is an ion pump involved?Therefore, in any metabolic acidosis you'll have increased anion gap unless the chloride compensates for the depressed bicarb.
- anion gap = Na - Cl and HCO3
- metabolic acidosis means low bicarb
Therefore, any normal anion gap metabolic acidosis is essentially hyperchloremic metabolic acidosis. See normal anion gap mnemonic thread
In proximal renal tubular acidosis you have failure of bicarbonate reabsorption and this will be compensated by chloride reabsorption to maintain neutrality across the renal tubule membrane. See this thread for a similar issue
Yes, in the proximal convoluted tubules you have 60% reabsorption of Sodium and that's coupled with 15% bicarb and 45% Chloride absorption to maintain electrical neutrality.thank you. what i really want to know is what is the mechanism for hyperchloremia. in rta. is an ion pump involved?
thanks a million for this. it makes perfect sense.Yes, in the proximal convoluted tubules you have 60% reabsorption of Sodium and that's coupled with 15% bicarb and 45% Chloride absorption to maintain electrical neutrality.
When that 15% bicarb decrease (such as Type II RTA) then the 45% Chloride absorption increases and there you have the hyperchloremia.
