Jacobi J, Schnellhardt S, Opgenoorth M, Amann KU, Küttner A, Schmid A, Eckardt KU, Hilgers KF. Severe metabolic alkalosis and recurrent acute on chronic kidney injury in a patient with Crohn's disease.
BMC Nephrol 2010;
11:6. [PMID:
20398419 PMCID:
PMC2862025 DOI:
10.1186/1471-2369-11-6]
[Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Accepted: 04/18/2010] [Indexed: 11/10/2022] Open
Abstract
Background
Diarrhea is common in patients with Crohn's disease and may be accompanied by acid base disorders, most commonly metabolic acidosis due to intestinal loss of bicarbonate.
Case Presentation
Here, we present a case of severe metabolic alkalosis in a young patient suffering from M. Crohn. The patient had undergone multiple resections of the intestine and suffered from chronic kidney disease. He was now referred to our clinic for recurrent acute kidney injury, the nature of which was pre-renal due to profound volume depletion. Renal failure was associated with marked hypochloremic metabolic alkalosis which only responded to high volume repletion and high dose blockade of gastric hypersecretion. Intestinal failure with stomal fluid losses of up to 5.7 litres per day required port implantation to commence parenteral nutrition. Fluid and electrolyte replacement rapidly improved renal function and acid base homeostasis.
Conclusions
This case highlights the important role of gastrointestinal function to maintain acid base status in patients with Crohn's disease.
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