1/2. Severe recurrent alkalemia in a patient undergoing continuous cyclic peritoneal dialysis.Chronic renal failure is commonly associated with acid-base disorders that are corrected with the institution of maintenance peritoneal dialysis. Severe shifts in systemic pH that occur in patients undergoing peritoneal dialysis are usually acidemic shifts due to inadequate replacement of the kidney's ability to excrete acid and regenerate bicarbonate. This report describes a severe alkalemic shift in pH in a patient undergoing continuous cyclic peritoneal dialysis due to a failure of dialysis to substitute for the kidney's normal response to simple respiratory alkalosis. This case emphasizes that in patients undergoing peritoneal dialysis, physicians must actively provide the "renal compensation" for an acid-base disorder and change the dialysis prescription.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/2. hyperventilation syndrome. Bridging the behavioral-organic gap.hyperventilation syndrome is frustrating to patient and physician alike. This common condition can be managed successfully if the primary care physician understands the pathophysiology of symptoms and takes a persistent, supportive approach to the patient. Invasive testing and psychiatric referral are less effective and more costly than an ongoing relationship with a primary care physician. Positive results are most likely to derive from frequent office visits marked by reassurance and repetition of instructions on how to cope with anxiety and its attendant symptoms.- - - - - - - - - - ranking = 3keywords = physician (Clic here for more details about this article) |