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Metabolic alkalosis due to short bowel syndrome in a hemodialysis patient

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Abstract

A 53-year-old man on hemodialysis suffered from short bowel syndrome after subtotal colectomy and partial resection of the small intestine. Laboratory tests showed multiple electrolyte disorders and enlarged sodium and chloride ion (Cl−) gaps despite treatment with large volume of sodium chloride replacement via central venous infusion. Blood gas analysis showed slightly high bicarbonate ion levels and metabolic alkalosis was suspected, which is uncommon in end stage kidney disease. The measurement of electrolytes in feces from ileostomy showed relatively high Cl− excretion. The loss of Cl− to feces may have caused the metabolic alkalosis; thus, additional Cl− replacement may have been necessary.

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Author notes

  1. Satoshi Masuyama

    Present address: Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

  2. Saho Kawanishi & Hiroki Nomi

    Present address: Department of Nephrology, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan

  3. Atsuyuki Tokuyama

    Present address: Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Okayama, Japan

Authors and Affiliations

  1. Department of Nephrology, Osaka Rosai Hospital, Sakai, Osaka, Japan

    Satoshi Masuyama, Katsuyuki Nagatoya, Takayuki Kawaoka, Saho Kawanishi, Hiroki Nomi, Aki Warada, Atsuyuki Tokuyama, Ryota Haga, Daisuke Mori & Atsushi Yamauchi

  2. Department of Nephrology, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan

    Takayuki Kawaoka

Authors
  1. Satoshi Masuyama
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  2. Katsuyuki Nagatoya
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  3. Takayuki Kawaoka
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  4. Saho Kawanishi
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  5. Hiroki Nomi
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  6. Aki Warada
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  7. Atsuyuki Tokuyama
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  8. Ryota Haga
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  9. Daisuke Mori
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  10. Atsushi Yamauchi
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Corresponding author

Correspondence to Katsuyuki Nagatoya.

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Masuyama, S., Nagatoya, K., Kawaoka, T. et al. Metabolic alkalosis due to short bowel syndrome in a hemodialysis patient. CEN Case Rep 9, 162–164 (2020). https://doi.org/10.1007/s13730-020-00445-1

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  • DOI: https://doi.org/10.1007/s13730-020-00445-1

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