Could somone expl this concept.
1. Pls Explain what this means restistance vs sensitive CL M Acidosis. (What is the cause of high or low urinary CL??)
2. Which lab values tell syou if it is Cl resistant or sensitive (serum or urinary Cl levels)
thx
its metabolic alkalosisi which is cl sesitive and resistant . e.g in vomiting u lose ur HCL , so u have to replace with Nacl( vomiting respond to cl replacement ) urinary cl is >20.
while in hyperaldostetonism urinary cl is >20, , treat it with spiranolactone
- we check chloride in urine
guys correct me if i am wrong
Ok Pls confrim this to see if i understood this rite
In Cl responsive
1.Vomit
---CL lost in vomit => low Cl levels are sensed in Kidney and that activates ren-ang-aldost, which in turn => incr NaCl reabs. & K/H secrtion =>urinary Cl low.
2.Thiazide diurectics
---inhibt cotransport of Na/CL and again => incr delivery to distal duct plus the hypovolemia cause renin-ang-aldost....=> urinary Cl high
In Cl resistant
1. Barter
--Na/K/Cl cotrans imp absorbt., also loose ca into urine ==> incr delivery again to distal collect ==> activate reni-ang-aldost = > incr NaCl at distal collect duct and excrete K/H
but why is this called resistant, b/c even in Barters we end up reabs NaCl thru aldost activation??
Can u guys confrim??
lala, anyone have a comment, ajeet maybe you can shed some light