#104: Renal tubular acidosis with Kidney Boy, Joel Topf MD

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 16 July 2018

⏱️ 76 minutes

🔗️ Recording | iTunes | RSS

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Summary

Renal tubular acidosis aka RTA deconstructed by @Kidney_Boy, Joel Topf MD, Chief of Nephrology at Kashlak Memorial Hospital. We review the three buckets of non gap metabolic acidosis, normal renal physiology & acid base handling, points of failure in RTA, complications and treatment of RTA. Check out Dr Topf’s awesome slides on renal tubular acidosis at http://thecurbsiders.com/podcast .

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Credits:

Written by: Matthew Watto MD and Joel Topf MD
Produced by: Matthew Watto MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
Guest: Joel Topf MD

Time Stamps

00:00 Announcements
01:02 Disclaimer
01:40 Intro and guest bio
04:00 Joel’s one liner
06:05 Joel’s “favorite failure”
11:45 Paul shares a failure
13:20 Tweetorials
16:39 Clinical case of non gap metabolic acidosis
18:06 Three buckets of NAGMA and GI losses
21:02 Chloride intoxication and normal saline
25:14 Renal tubular acidosis and normal role of kidney in acid base
35:03 Proximal (type 2) RTA
40:33 Cases of proximal RTA
43:38 Distal (type 1) RTA
53:15 Bicarbonate dosing and titration
55:28 Type 4 RTA (hypoaldosteronism)
62:09 Urinary anion gap and ammonium
67:26 Replacing GI losses of bicarbonate
70:25 Joel reviews quick cases of RTA and NAGMA
74:49 Outro

Tags: renal, tubular, acidosis, non, gap, rta, nagma, metabolic, kidney, diarrhea, sodium, normal, saline, ringer's, lactate, tubule, bicarbonate, physiology, acid, base, ammonia, ammonium, nephrolithiasis, assist

Transcript

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0:00.0	On this episode of the Curbsiders, we will once again be talking with Dr. Joel Tough or
0:07.9	as he's better known on Twitter at kidney underscore boy.
0:12.1	And since I know this is the time of year where we are generally picking up a lot of new
0:16.4	listeners, I wanted to let you know that on most shows we spend the first 10 minutes hanging
0:21.8	out kind of for our own wellness, talking about work life integration, things we're reading,
0:27.3	things we're doing for professional development.
0:30.0	If that doesn't interest you, then you can skip right ahead this episode for the first
0:34.6	about 15 minutes after this intro.
0:37.2	We will be talking with Joel about a favorite failure of his and a little bit about Twitter.
0:42.9	If that doesn't interest you, you can skip right ahead.
0:46.1	As always, we have timestamps that go along with the show so you can always look at those
0:49.7	to see where we actually get into the topic.
0:52.4	But as Dr. Paul Williams will tell you, we highly recommend you.
0:57.0	This is the first 10 to 15 minutes of the show because it makes you a better person.
1:00.9	And with that being said, enjoy the show.
1:26.8	Welcome back to the Curbsiders.
1:40.3	Well, hi, Matt.
1:41.3	How are you doing?
1:42.3	Good.
1:43.3	How's life?
1:44.3	Life is good.
1:45.3	We were just talking about all the interesting emails and offers we've been getting for the
	...

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