A Rare Case of Severe Metabolic Alkalosis with Unusual Hyperproteinemia Treated with Continuous Renal Replacement Therapy and Regional Citrate Anticoagulation
A 23-year-old woman was referred to the tertiary centre with acute kidney injury and severe metabolic alkalosis following an accidental ethylene glycol poisoning. The patient had been treated with continuous haemodiafiltration and regional citrate anticoagulation, and a tracheostomy was performed du...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2018-08-01
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| Series: | Case Reports in Nephrology and Dialysis |
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| Online Access: | https://www.karger.com/Article/FullText/491628 |
| _version_ | 1819319321280643072 |
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| author | Vojtěch Matoušek Ivan Herold Lenka Holanová Martin Balík |
| author_facet | Vojtěch Matoušek Ivan Herold Lenka Holanová Martin Balík |
| author_sort | Vojtěch Matoušek |
| collection | DOAJ |
| description | A 23-year-old woman was referred to the tertiary centre with acute kidney injury and severe metabolic alkalosis following an accidental ethylene glycol poisoning. The patient had been treated with continuous haemodiafiltration and regional citrate anticoagulation, and a tracheostomy was performed due to pneumonia. Besides severe metabolic alkalosis and hypernatremia, the laboratory tests revealed total protein of 108 g/L on admission to the tertiary centre. The haemodiafiltration with regional citrate anticoagulation continued with parallel correction of the alkalosis and normalisation of the total plasma protein. The tracheostomy was decannulated and the patient was discharged to the district hospital. The case demonstrates the usefulness of regional citrate anticoagulation even in severe metabolic alkalosis which was likely related to the method setting prior to admission and to an overcompensation of the initial severe metabolic acidosis. The unusual hyperproteinaemia might be interpreted with the aid of the Stewart-Fencl model of the acid-base regulation. |
| first_indexed | 2024-12-24T11:01:50Z |
| format | Article |
| id | doaj.art-135f8e46e73e47f9a88bf668ab0d0bce |
| institution | Directory Open Access Journal |
| issn | 2296-9705 |
| language | English |
| last_indexed | 2024-12-24T11:01:50Z |
| publishDate | 2018-08-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Nephrology and Dialysis |
| spelling | doaj.art-135f8e46e73e47f9a88bf668ab0d0bce2022-12-21T16:58:42ZengKarger PublishersCase Reports in Nephrology and Dialysis2296-97052018-08-018213814610.1159/000491628491628A Rare Case of Severe Metabolic Alkalosis with Unusual Hyperproteinemia Treated with Continuous Renal Replacement Therapy and Regional Citrate AnticoagulationVojtěch MatoušekIvan HeroldLenka HolanováMartin BalíkA 23-year-old woman was referred to the tertiary centre with acute kidney injury and severe metabolic alkalosis following an accidental ethylene glycol poisoning. The patient had been treated with continuous haemodiafiltration and regional citrate anticoagulation, and a tracheostomy was performed due to pneumonia. Besides severe metabolic alkalosis and hypernatremia, the laboratory tests revealed total protein of 108 g/L on admission to the tertiary centre. The haemodiafiltration with regional citrate anticoagulation continued with parallel correction of the alkalosis and normalisation of the total plasma protein. The tracheostomy was decannulated and the patient was discharged to the district hospital. The case demonstrates the usefulness of regional citrate anticoagulation even in severe metabolic alkalosis which was likely related to the method setting prior to admission and to an overcompensation of the initial severe metabolic acidosis. The unusual hyperproteinaemia might be interpreted with the aid of the Stewart-Fencl model of the acid-base regulation.https://www.karger.com/Article/FullText/491628Citrate accumulationContinuous renal replacement therapyHyperproteinaemiaMetabolic alkalosisRegional citrate anticoagulationStewart-Fencl acid base concept |
| spellingShingle | Vojtěch Matoušek Ivan Herold Lenka Holanová Martin Balík A Rare Case of Severe Metabolic Alkalosis with Unusual Hyperproteinemia Treated with Continuous Renal Replacement Therapy and Regional Citrate Anticoagulation Case Reports in Nephrology and Dialysis Citrate accumulation Continuous renal replacement therapy Hyperproteinaemia Metabolic alkalosis Regional citrate anticoagulation Stewart-Fencl acid base concept |
| title | A Rare Case of Severe Metabolic Alkalosis with Unusual Hyperproteinemia Treated with Continuous Renal Replacement Therapy and Regional Citrate Anticoagulation |
| title_full | A Rare Case of Severe Metabolic Alkalosis with Unusual Hyperproteinemia Treated with Continuous Renal Replacement Therapy and Regional Citrate Anticoagulation |
| title_fullStr | A Rare Case of Severe Metabolic Alkalosis with Unusual Hyperproteinemia Treated with Continuous Renal Replacement Therapy and Regional Citrate Anticoagulation |
| title_full_unstemmed | A Rare Case of Severe Metabolic Alkalosis with Unusual Hyperproteinemia Treated with Continuous Renal Replacement Therapy and Regional Citrate Anticoagulation |
| title_short | A Rare Case of Severe Metabolic Alkalosis with Unusual Hyperproteinemia Treated with Continuous Renal Replacement Therapy and Regional Citrate Anticoagulation |
| title_sort | rare case of severe metabolic alkalosis with unusual hyperproteinemia treated with continuous renal replacement therapy and regional citrate anticoagulation |
| topic | Citrate accumulation Continuous renal replacement therapy Hyperproteinaemia Metabolic alkalosis Regional citrate anticoagulation Stewart-Fencl acid base concept |
| url | https://www.karger.com/Article/FullText/491628 |
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