Nephrocalcinosis fortuitously discovered: the role of surreptitious self administration of diuretics
Background: Furosemide is a drug widely used for several medical conditions and could be used without medical prescription. Furosemide-related nephrocalcinosis can occur regardless of age, although the risk is higher in premature infants. The defining characteristic of nephrocalcinosis is generalize...
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| Format: | Article |
| Language: | English |
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Babol University of Medical Sciences
2024-01-01
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| Series: | Caspian Journal of Internal Medicine |
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| Online Access: | http://caspjim.com/article-1-3709-en.pdf |
| _version_ | 1827381137061707776 |
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| author | Nery Sablon Gonzalez Liliana Moran Caicedo Maria Belen Alonso Ortiz Yanet Parodis Lopez Angelica Laurin Emmanuel Andrès Noel Lorenzo Villalba |
| author_facet | Nery Sablon Gonzalez Liliana Moran Caicedo Maria Belen Alonso Ortiz Yanet Parodis Lopez Angelica Laurin Emmanuel Andrès Noel Lorenzo Villalba |
| author_sort | Nery Sablon Gonzalez |
| collection | DOAJ |
| description | Background: Furosemide is a drug widely used for several medical conditions and could be used without medical prescription. Furosemide-related nephrocalcinosis can occur regardless of age, although the risk is higher in premature infants. The defining characteristic of nephrocalcinosis is generalized calcium deposition in the kidney. The most useful imaging studies for evaluation are ultrasonography and computed tomography (more effective in detecting calcification).
Case Presentation: A 32-year-old woman with a history of depressive syndrome was admitted for evaluation of fortuitously discovered nephrocalcinosis and hypokalemia. The studies performed revealed the presence of a metabolic alkalosis with discrete hyperreninism/hyperaldosteronism but normal ratio, normotension and urinary study showed elevated sodium, chloride, potassium and calcium fluctuating in different determinations. Surreptitious diuretic intake was suspected and urine analysis revealed doses equivalent to 80-120 mg. The patient was advised to discontinue all diuretic treatment; she was adequately supplemented with potassium and she was followed-up in outpatient clinics. During the follow-up, clinical and analytical improvement was noted, which led to the discontinuation of supplementation.
Conclusion: Surreptitious diuretic intake is a clinical condition to rule out in patients with chronic hypokalemia, metabolic alkalosis with elevated urinary sodium and chloride. The relation between surreptitious diuretic intake and nephrocalcinosis has not been fully elucidated in adults. |
| first_indexed | 2024-03-08T13:49:50Z |
| format | Article |
| id | doaj.art-f62c1f859de74dd8aa5ee5eb0b06821c |
| institution | Directory Open Access Journal |
| issn | 2008-6164 2008-6172 |
| language | English |
| last_indexed | 2024-03-08T13:49:50Z |
| publishDate | 2024-01-01 |
| publisher | Babol University of Medical Sciences |
| record_format | Article |
| series | Caspian Journal of Internal Medicine |
| spelling | doaj.art-f62c1f859de74dd8aa5ee5eb0b06821c2024-01-16T05:27:41ZengBabol University of Medical SciencesCaspian Journal of Internal Medicine2008-61642008-61722024-01-01151184187Nephrocalcinosis fortuitously discovered: the role of surreptitious self administration of diureticsNery Sablon Gonzalez0Liliana Moran Caicedo1Maria Belen Alonso Ortiz2Yanet Parodis Lopez3Angelica Laurin4Emmanuel Andrès5Noel Lorenzo Villalba6 Servicio de Nefrologia. Hospital Universitario de Gran Canaria Dr. Negrin. Spain Servicio de Nefrologia. Hospital Universitario del Tajo. Spain Servicio de Medicina Interna. Hospital Universitario de Gran Canaria Dr. Negrin. Spain Centro de Hemodialisis AVERICUM. Las Palmas de Gran Canaria. Spain Centro de Atencion Primaria Barrio Atlantico. Las Palmas de Gran Canaria. Spain Service de Médecine Interne, Diabète et Maladies Métaboliques. Hôpitaux Universitaires de Strasbourg. France Service de Médecine Interne, Diabète et Maladies Métaboliques. Hôpitaux Universitaires de Strasbourg. France Background: Furosemide is a drug widely used for several medical conditions and could be used without medical prescription. Furosemide-related nephrocalcinosis can occur regardless of age, although the risk is higher in premature infants. The defining characteristic of nephrocalcinosis is generalized calcium deposition in the kidney. The most useful imaging studies for evaluation are ultrasonography and computed tomography (more effective in detecting calcification). Case Presentation: A 32-year-old woman with a history of depressive syndrome was admitted for evaluation of fortuitously discovered nephrocalcinosis and hypokalemia. The studies performed revealed the presence of a metabolic alkalosis with discrete hyperreninism/hyperaldosteronism but normal ratio, normotension and urinary study showed elevated sodium, chloride, potassium and calcium fluctuating in different determinations. Surreptitious diuretic intake was suspected and urine analysis revealed doses equivalent to 80-120 mg. The patient was advised to discontinue all diuretic treatment; she was adequately supplemented with potassium and she was followed-up in outpatient clinics. During the follow-up, clinical and analytical improvement was noted, which led to the discontinuation of supplementation. Conclusion: Surreptitious diuretic intake is a clinical condition to rule out in patients with chronic hypokalemia, metabolic alkalosis with elevated urinary sodium and chloride. The relation between surreptitious diuretic intake and nephrocalcinosis has not been fully elucidated in adults.http://caspjim.com/article-1-3709-en.pdfnephrocalcinosishypokalemiafurosemide |
| spellingShingle | Nery Sablon Gonzalez Liliana Moran Caicedo Maria Belen Alonso Ortiz Yanet Parodis Lopez Angelica Laurin Emmanuel Andrès Noel Lorenzo Villalba Nephrocalcinosis fortuitously discovered: the role of surreptitious self administration of diuretics Caspian Journal of Internal Medicine nephrocalcinosis hypokalemia furosemide |
| title | Nephrocalcinosis fortuitously discovered: the role of surreptitious self administration of diuretics |
| title_full | Nephrocalcinosis fortuitously discovered: the role of surreptitious self administration of diuretics |
| title_fullStr | Nephrocalcinosis fortuitously discovered: the role of surreptitious self administration of diuretics |
| title_full_unstemmed | Nephrocalcinosis fortuitously discovered: the role of surreptitious self administration of diuretics |
| title_short | Nephrocalcinosis fortuitously discovered: the role of surreptitious self administration of diuretics |
| title_sort | nephrocalcinosis fortuitously discovered the role of surreptitious self administration of diuretics |
| topic | nephrocalcinosis hypokalemia furosemide |
| url | http://caspjim.com/article-1-3709-en.pdf |
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