Severe metabolic alkalosis and recurrent acute on chronic kidney injury in a patient with Crohn's disease

BMC Nephrology

Case Report

Kai-Uwe Eckardt¹  Mirian Opgenoorth¹  Johannes Jacobi¹  Susanne Schnellhardt¹  Karl F Hilgers¹  Kerstin U Amann²  Axel Schmid³  Axel Küttner³ 

[1] Department of Nephrology and Hypertension, University Erlangen-Nuremberg, Erlangen, Germany;Institute of Pathology, University Erlangen-Nuremberg, Erlangen, Germany;Institute of Radiology, University Erlangen-Nuremberg, Erlangen, Germany;

关键词: Short Bowel Syndrome;    Metabolic Alkalosis;    Gastric Inhibitory Polypeptide;    Intestinal Failure;    Intercalate Cell;   

DOI  :  10.1186/1471-2369-11-6

 received in 2009-08-31, accepted in 2010-04-18,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundDiarrhea 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 PresentationHere, 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.ConclusionsThis case highlights the important role of gastrointestinal function to maintain acid base status in patients with Crohn's disease.

【 授权许可】

CC BY   
© Jacobi et al; licensee BioMed Central Ltd. 2010