Medline ® Abstract for Reference 39
of 'Clinical manifestations and treatment of hypokalemia in adults'
39
TI
Combined renal tubular acidosis and diabetes insipidus in hematological disease.
AU
Hoorn EJ, Zietse R
SO
Nat Clin Pract Nephrol. 2007;3(3):171.
BACKGROUND:
A 39-year-old male with multiple myeloma was admitted for treatment with melphalan and autologous stem cell reinfusion. He presented with hypokalemia and hyperchloremic non-anion-gap metabolic acidosis with a high urinary pH. He also had hypomagnesemia, hypophosphatemia, hypouricemia, proteinuria and glucosuria. The patient subsequently developed polyuria with a low urine osmolality, hypernatremia and, finally, acute renal failure.
INVESTIGATIONS:
Physical examination, blood and urine analyses, kidney biopsy and tonicity balance.
DIAGNOSIS:
Fanconi syndrome with proximal (type II) renal tubular acidosis caused by myeloma kidney. Renal tubular acidosis was complicated by probable nephrogenic diabetes insipidus and acute renal failure.
MANAGEMENT:
Potassium supplementation, sodium bicarbonate therapy, intravenous fluid therapy and dialysis.
AD
Erasmus Medical Center, Rotterdam, The Netherlands. ejhoorn@gmail.com
PMID