Renal Tubular Acidosis is a medical condition. When the kidney is unable to acidify urine, it leads to the accumulation of acid in the body. Usually, when blood is filtered by the kidney, it passes through the tubules of the nephrons (the functional unit of the kidney).

Before it flows into the bladder from the kidney, the urine undergoes an exchange of salts, acids and other solutes. Renal tubular acidosis results in the formation of excessive amounts of acid because the kidneys cannot drain them. This may happen because the kidneys cannot reabsorb the alkaline bicarbonate ions from the urine in the early segment of the nephron or because of inadequate production of acidic hydrogen ions in the latter half of the nephron.

Renal Tubular Acidosis is simply associated with abnormal urinary acidification. Other functions of the kidneys remain unimpaired.
There are several different types of renal tubular acidosis-

  Distal Renal Tubular Acidosis (RTA)
This is the most fundamental form of RTA. It is characterized when the hydrogen ions are not secreted into the lumen of the nephron by the alpha-intercalated cells of the medullary collective duct of the distal nephron. When this happens the pH of urine cannot be brought down below 5.3. Renal excretion is inhibited and hydrogen ions are not eliminated which leads to academia. At the same time, Potassium ions cannot be absorbed by the cell which leads to hypokalemia. The end result is protein retention and potassium excretion. Distal RTA can lead to the urinary stone formation, calcium deposits in the kidney, rickets and osteomalacia and Sjogren s syndrome.

  Proximal RTA
When proximal tubular cells reabsorb 85% of filtered bicarbonates and 60% of filtered sodium from the urine, then this again leads to academia. The distal intercalated cells, however, function normally and so the academia is not as severe as in case of Distal RTA. The alpha-intercalated cells can acidify urine to a pH of 5.3 or less because they produce hydrogen ions. Proximal RTA is also associated with Fanconi Syndrome which is characterized by aminoaciduria, uricosuria, glucosuria, and tubular proteinuria.

  Combined distal and proximal RTA
Inherited carbonic anhydrase II deficit leads to combined distal and proximal RTA. This is accompanied by osteopetrosis, cerebral calcification, and renal tubular acidosis. Cases of combined distal and proximal RTA are very rare.

How is RTA understood?
The following steps are applied to analyze Renal Tubular Acidosis-
  Determining the anion gap in acidosis. The normal Anion Gap is 8-12 (4-6 mEq/L)
  Separating the renal from the extrarenal causes of normal anion gap acidosis
  Classifying the types of RTA
  If it is distal RTA, further tests will be necessary to support the diagnosis

How is RTA diagnosed?
Three types of tests can reveal if a person is affected by Renal Tubular Acidosis-
  Urine test
  Acid load test
  Physical examination

Treatment of RTA-
Doctors prescribe either or both of the following two types of therapies-

  Alkali therapy- The pH level of urine is restored and electrolytes are balanced
  Vitamin D supplements- If RTA leads to bone deformities or rickets, your doctor will prescribe vitamin supplements to strengthen your bones.

Timely diagnosis can prevent the effects of Renal tubular Acidosis from becoming compounded. With the right medication, a person can lead a healthy normal life.

What Should You Know About Renal Tubular Acidosis?

Common causes of sleep apnea:
Sleep apena is a major cause of snoring. It can be caused because of allergies, obesity, gastroesophageal reflux disease (GERD) etc. In children sleep, apnea can also be caused by tonsil. Since the tonsil size of children less than 7 years of age tends to be bigger than adult individuals, it causes snoring related problem. Swollen tonsils not only obstruct air but creates other health related problems as well.

Symptoms of sleep apnea during the day and night:

Loud snore
Snorts, gasps, pauses during sleep
Heavy sweat during sleep
Social and behavioural problems
Failure to get up in the morning
A nasal voice
Easily irritated, cranky and aggressive
Relief measure:
The first thing a that a doctor does is a physical exam followed by observing the symptoms of a kid. Primary snorting can be addressed by physical exercise, counselling and breathing exercise. Problems related to apnea are addressed through medicine, counselling, and exercise. Certain dietary restrictions also needed to be followed during this time. However, apena is completely treatable within a certain time frame.

Mouth Breathing - What Can Cause It?

5 Signs of an Unhealthy Heart

The heart is a muscular organ that helps to pump blood through the circulatory system by periodic contractions and relaxations. The heart is one of the most important organs of the body so much so that a single cardiac arrest or a heart attack can lead to fatal consequences. Even so, a heart attack is one of the most leading causes of death in the country. But there are some earlier symptoms that could alert you ahead of time. The following are signs of an unhealthy heart:

1. Sexual problems

Erectile dysfunction (ED) is one of the most predictable reasons for cardiovascular conditions. Today, patients who are diagnosed with ED are also considered as cardiovascular patients. This is because the heart is supposedly not able to pump enough blood to the genital area. In case of women, reduced blood flow can hamper arousal and delay orgasms.

2. Snoring and sleep apnea

If one snores loudly enough to prevent their partner's from sleeping or resort to using earplugs, one may be at a risk of having a weak heart. Restricted breathing during sleep is connected with a host of cardiovascular diseases. Sleep apnea, a condition where breathing stops for a brief span of time, is linked with higher cardiovascular risks.

3. Swollen, sore and bleeding gums

Swollen and bleeding gums are not only symptoms of dental conditions but also of cardiovascular difficulties. Medical experts believe poor circulation of blood arises due to underlying heart conditions. Recent studies are focusing on bacteria that are believed to cause gum disease as well as plaque inside the arteries of the heart.

4. Heart Arrhythmia

Irregular heartbeat or heart arrhythmia is a common sign of a weak heart. It is characterized by both fast and slow beating of the heart. Restricted blood flow to the heart strains the electrical signals that maintain the normal beating of the heart. This is one of the common causes of coronary artery diseases.

5. Chest pain

One of the most apparent signs of coronary artery diseases is chest pain. The cause of the sharp, clutching pain in your chest can be build-up of plaque in the arteries, which could lead to fatal consequences.



5 Signs of an Unhealthy Heart

Coronary artery disease or CAD is the name given to the heart condition in which the major blood vessels that supply your heart with blood, oxygen and nutrients, also called coronary arteries, get blocked, damaged or diseased.

Blockages usually happen when cholesterol-containing deposits called plaque deposit in your arteries. Plaque narrows the lumen of your coronary artery which means your heart gets lesser and lesser oxygen and nutrients to function properly.
Inflammation is also to blame for coronary artery disease.
Common symptoms of CAD include

Angina or pain in the chest
Shortness of breath
If the blockage is complete, you can get a heart attack.
Common Diagnostic tests
When you go to a heart specialist, she will ask questions about your medical history and follow it up with a physical exam and order routine blood and diagnostic tests to confirm CAD like:

Electrocardiogram (ECG): An ECG records electrical signals as they travel through your heart revealing evidence of a previous heart attack or one that s happening. Holter monitoring is a type of ECG where you wear a portable monitor for 24 hours as you go about your normal daily activities. Abnormalities in the results suggest reduced blood flow to the heart signaling CAD.
Echocardiogram: This test uses sound waves to produce images of your heart. It helps your doctor determine whether all parts of your heart wall are contributing to your heart's pumping activity. If certain parts are moving weakly it can mean damage to muscle due to a heart attack or because of receiving too little oxygen- again signaling CAD.
Exercise Stress test: This test is done by making you do exercises like walking on a treadmill or riding a stationary bike during an ECG. Sometimes, medication to stimulate your heart may be used instead of exercise.
This again detects areas in your heart that receive less blood flow.

Cardiac catheterization or angiogram. A special dye is injected into your coronary arteries to observe blood flow through your heart in a test known as an angiogram.
The dye is sometimes also injected into the arteries through a long, thin, flexible tube called catheter that is threaded through an artery in your leg to the arteries in your heart. This procedure is called cardiac catheterization. This test is very good in diagnosing CAD as the dye outlines narrow spots and blockages on the X-ray images of your heart.
Heart scans. Computerized tomography or CT can help your doctor actually see calcium deposits in your arteries that can be narrowing your arteries. If a substantial amount of calcium deposits are found, coronary artery disease could be the reason.
MRI scans are also done to diagnose CAD.

Common Tests For Coronary Artery Disease!

Things to do in case of chest pain or angina pain

Unlike yesteryears chest pain or heart related problems aren’t just age related anymore. Many young people under 30 are experiencing chest pain. It seems to be directly proportional to the increasing stress levels.The medical term for mild chest pain is angina pectoris and it happens when your heart is not getting its usual requirement for blood. Such a situation occurs when one or more arteries are blocked. Angina Pectoris is experienced usually while doing physical activities or experiencing strong emotions. At such times, the heart doesn't get as much blood as it requires for normal functioning.

Broadly speaking, discomfort in the upper part of the body is the symptom of angina, the symptoms typically include:

1.  It may feel like you are suffering from indigestion or gas or fullness and pressure.

2.  It may also feel like chest pain spreading to the neck, back, arms, shoulder or jaw.

3. You feel better after a little rest or some medication.

4. It doesn't last for too long, at the most five minutes.

5. Shortness of breath, anxiety, dizziness, sweating, fatigue and nausea and also symptoms of angina.

Physical conditions and habits which put you at the high risk zone for angina are:
1. When you don't get enough exercise.
2. If you are a smoker
3. If you are overweight
4.  If you have a history of heart diseases
5. If you are diabetic
6. If you suffer from blood pressure of high cholesterol

Steps You Must Do To Manage the Pain and Resultant Effects

1. Calm Down - The first thing to do to counter angina pains is to rest and calm down. If you are doing physical activity, stop doing it. And if you are under emotional turbulence, you need to find ways to calm down immediately. Meditate, if needed.

2. Get Professional Help - Do not delay in consulting the doctor and ensure that you take the prescribed medication diligently. In situations where the damage is much more and medications cannot clear the problem, surgery is resorted to.

3. Change Of Lifestyle - In the long run, lifestyle change is a good idea. Staying fit, a clean medical report and keeping a healthy lifestyle will keep enough blood pumping into your heart.

If you would like to consult with me privately, please click on 'Consult'.

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Why You Must Not Dismiss Chest Pain as a Minor Affair!

Be it burgers, bagels, muffins, sandwiches or simple toasts, bread has made headway into the diets of a huge portion of the populace. Although a staple diet for many since time immemorial, the consumption of bread has increased extensively in the recent past. But, which type of bread should we intake to incur the best health impacts is a question that bothers many. The general assumption is that the wholegrain variety is the best alternative. However, the barrage of marketing tactics makes it impossible to distinguish the best variety from the others. 

There are a whole lot of myths surrounding the best variety of bread and you must choose wisely before settling for one particular type. It is expedient to look beyond the overt appearance or the name of the bread, one needs to be wary of the ingredient before taking a call.

Mostly, white bread is made out of refined flour which is often striped off essential nutrients and fibers. To worsen the situation, white bread is often bleached with certain chemicals to enhance its appearance.
Certain assumptions deem brown bread as the healthier option. Unfortunately, it isn't true always. More often than not, brown bread is simply white bread with artificial coloring added to it or is caramelized. They essentially add no surplus nutritional value.

Similarly, multigrain bread can often mislead the consumers about its health impacts. Unlike whole wheat bread, multigrain breads are usually chemically treated with softened grains. This does not effectively recover the lost nutrients of the bread.

Whole wheat bread has more pronounced health benefits. It contains more wheat germ and fibers in comparison to the more processed varieties of bread. Having evaded the toxic additives, it has relatively healthier effects on our blood sugar levels.

As you realize that the bread that you eat does not necessarily affect your health favorably, wisdom lies in seeking out the least harmful variety. In that context, rye bread or spelt bread contains greater amount of minerals. Besides, bread made from barley, oats and millets have greater mineral content than the commercially hybridized varieties and promote better health.

Brown Bread Vs White Bread Vs Whole Grain?

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