Nephrol Dial Transplant (2002) 17: 929-930
© 2002 European Renal Association-European Dialysis and Transplant Association
Nephroquiz
An uncommon cause of metabolic acidosis in a haemodialysis patient
(Section Editor: M. G. Zeier)
Division of Nephrology, Department of Medicine, Hannover Medical School, Hannover, Germany Email: Woywodt.Alexander@MH-Hannover.de
Case
A 40-year-old haemodialysis patient presented with hyperkalaemia of 7.1 mmol/l on his scheduled day of dialysis treatment. On examination, he appeared unwell, tachypnoeic and diaphoretic. His abdomen was non-tender with scars from recent surgery (Figure 1
). The remainder of the clinical examination was unremarkable. Compliance had always been excellent so arterial blood gas analysis was performed in search of a cause for this new and unexpected hyperkalaemia. The findings were: pH 7.325, pO2 102 mmHg, pCO2 24 mmHg, bicarbonate 12.5 mmol/l, sodium 140 mmol/l, chloride 108 mmol/l. The patient was afebrile, lactate, white blood count and C-reactive protein were all normal. The patient was a male insulin-dependent
Question
Answer to the quiz on preceding page
Notes
References