Citation

Matoušek V, Herold I, Holanová L, Balík M. Case Rep. Nephrol. Dial. 2018; 8(2): 138-146.

Copyright

(Copyright © 2018, Karger)

DOI

10.1159/000491628

PMID

unavailable

Abstract

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. © 2018 The Author(s). Published by S. Karger AG, Basel.

Language: en

Keywords

adult; human; female; alcohol; case report; suicide attempt; disease severity; kidney failure; ethylene glycol; alcohol intoxication; vomiting; differential diagnosis; clinical article; priority journal; vertigo; intensive care unit; convulsion; sepsis; drug withdrawal; urinalysis; acute kidney failure; fever; hypernatremia; internal jugular vein; antibiotic agent; bicarbonate; diuresis; creatinine; creatinine blood level; urea; aspiration pneumonia; bronchoscopy; metabolic acidosis; thorax radiography; respiratory tract intubation; extubation; immunoassay; Article; unconsciousness; tracheostomy; metabolic alkalosis; heart left ventricle ejection fraction; plasma protein; continuous hemodiafiltration; anticoagulant therapy; calcium chloride; antipyretic agent; hyperlactatemia; stomach pain; young adult; thrombus; echocardiography; atelectasis; electrophoresis; assisted ventilation; continuous renal replacement therapy; unsteady gait; ataxic aphasia; Citrate accumulation Continuous renal replacement therapy Hyperproteinaemia Metabolic alkalosis Regional citrate anticoagulation Stewart-Fencl acid base concept; citrate trisodium; high dependency unit; hyperlipoproteinemia; hyperviscosity syndrome; hypogastric pain; light chain; polysulfone