{"podcast":{"title":"Channel Your Enthusiasm","slug":"channel-your-enthusiasm-1374325","podcast_index_feed_id":1374325,"rss_url":"http://www.rosebook.club/episodes/?format=rss","website_url":"http://www.rosebook.club/episodes/","image_url":"https://images.squarespace-cdn.com/content/v1/548bc7f6e4b0a269c594ebc2/1611689941077-BL32D22Z1P27G4UAVKEE/Screen+Shot+2021-01-26+at+2.34.41+PM.png?format=1500w","author":"joel topf","episode_count":31,"summary":"A chapter by chapter recap of Burton Rose’s classic, The Clinical Physiology of Acid Base and Electrolyte Disorders, a kidney physiology book for nephrologists, fellows, residents and medical students.","last_synced_at":null,"page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325"},"episode":{"title":"Chapter Nineteen: Metabolic Acidosis, part 3","slug":"chapter-nineteen-metabolic-acidosis-part-3","published_at":"2026-02-22T15:51:10+00:00","page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325/chapter-nineteen-metabolic-acidosis-part-3","show_page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325","url":"http://www.rosebook.club/episodes/2025/10/11/chapter19part3","audio_url":"https://static1.squarespace.com/static/548bc7f6e4b0a269c594ebc2/t/699b182025785065925440bb/1774318629790/Chapter+19+Metabolic+Acidosis%2C+part+3+of+3.mp3","summary":"References Chapter 19, Part 3 August 30, 2023 Joel and Roger mentioned the most common cause seems to be Sjögren’s syndrome for an acquired distal RTA. We mentioned this in an earlier episode and referenced this example of an absence of the H+ ATPase, presumably from autoantibodies to this transporter. Here’s a case report: Absence of H(+)-ATPase in cortical collecting tubules of a patient with Sjogren's syndrome and distal renal tubular acidosis  Joel mentioned this paper in the New England Journal of Medicine in which there were patients who had hyperkalemia with a distal RTA: Hyperkalemic Distal Renal Tubular Acidosis Associated with Obstructive Uropathy | NEJM in this setting, some patients   Anna mentioned this article on “ampho-terrible:” It’s the holes!!!    Yano T, Itoh Y, Kawamura E, Maeda A, Egashira N, Nishida M, Kurose H, Oishi R. Amphotericin B-induced renal tubular cell injury is mediated by Na+ Influx through ion-permeable pores and subsequent activation of mitogen-activated protein kinases and elevation of intracellular Ca2+ concentration. Antimicrob Agents Chemother. 2009 Apr;53(4):1420-6 Josh mentioned this study on furosemide’s effect on the TAL: Furosemide-induced urinary acidification is caused by pronounced H+ secretion in the thick ascending limb   Urinary acidification assessed by simultaneous furosemide and fludrocortisone treatment: an alternative to ammonium chloride - Kidney International Melanie mentioned treatment of patients with cystinosis Expert guidance on the multidisciplinary management of cystinosis in adolescent and adult patients | Clinical Kidney Journal | Oxford Academic Amy shared her observations regarding base supplements including Prevention of recurrent calcium stone formation with potassium ci…","meta_description":"References Chapter 19, Part 3 August 30, 2023 Joel and Roger mentioned the most common cause seems to be Sjögren’s syndrome for an acquired distal RTA. We…","key_points":[],"chapters":[],"topics":[],"duration_seconds":7078,"processing_state":"not_requested","actions":[{"name":"request_transcript","method":"POST","url":"https://stenobird.com/v1/public/podcasts/channel-your-enthusiasm-1374325/episodes/chapter-nineteen-metabolic-acidosis-part-3/transcription-requests","description":"Idempotently request low-priority transcript generation for this episode."},{"name":"read_markdown","method":"GET","url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325/chapter-nineteen-metabolic-acidosis-part-3.md","description":"Read the agent-friendly Markdown representation of this episode resource."}]}}