Korean J Med.
2009 Jun;76(6):764-768.
A case of severe metabolic acidosis after orthotopic neobladder replacement
- Affiliations
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- 1Department of Internal Medicine, Hallym Kidney Research Institute, College of Medicine, Hallym University, Seoul, Korea. km2071@unitel.co.kr
Abstract
- Following a radical cystectomy to treat bladder cancer, the ureters can be implanted in a short loop of ileum, which serves as an orthotopic bladder replacement. However, several investigators have reported the frequent development of a normal anion gap metabolic acidosis and electrolyte disturbance in these patients. The colon segments secrete sodium and bicarbonate ions and reabsorb ammonium, hydrogen, and chloride ions when exposed to urine, causing metabolic acidosis. In most cases, the acid-base disorder is not very troublesome. The metabolic acidosis can usually be corrected by administering sodium bicarbonate. We experienced a case of severe metabolic acidosis associated with urinary diversion that improved with continuous renal replacement therapy (CRRT).
Keyword
MeSH Terms
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Acid-Base Equilibrium
Acidosis
Bicarbonates
Colon
Cystectomy
Humans
Hydrogen
Ileum
Ions
Quaternary Ammonium Compounds
Renal Replacement Therapy
Research Personnel
Sodium
Sodium Bicarbonate
Ureter
Urinary Bladder
Urinary Bladder Neoplasms
Urinary Diversion
Bicarbonates
Hydrogen
Ions
Quaternary Ammonium Compounds
Sodium
Sodium Bicarbonate
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