Korean J Nephrol.
2010 Sep;29(5):600-605.
2 Cases of Severe Hyperchloremic Metabolic Acidosis after Orthotopic Neobladder Replacement and Augmentation Enterocystoplasty
- Affiliations
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- 1Department of Internal Medicine, Eulji University College of Medicine, Korea.
- 2Department of Internal Medicine, Seoul National University College of Medicine, Korea. junephro@snu.ac.kr
- 3Department of Urology, Seoul National University College of Medicine, Korea.
Abstract
- The use of intestinal segments in the reconstruction and plasty of urinary bladder for malignant or nonmalignant conditions is widely accepted. Metabolic derangements including hyperchloremic metabolic acidosis and malabsorption of lipid may occur after surgery. Main pathophysiology of hyperchloremic metabolic acidosis is the exchange of urinary chloride with luminal bicarbonate and duration of urine in contact with the intestinal mucosa can affect the severity of metabolic acidosis. We experienced two cases of severe hyperchloremic metabolic acidosis which developed in patients with chronic kidney disease, urinary tract infection and orthotopic neobladder or augmentation enterocystoplasty for the treatment of bladder cancer and neurogenic bladder, respectively.
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