A physiology-based approach to a patient with hyperkalemic renal tubular acidosis

Detalhes bibliográficos
Autor(a) principal: Menegussi,Juliana
Data de Publicação: 2018
Outros Autores: Tatagiba,Luiza Sarmento, Vianna,Júlia Guasti P., Seguro,Antonio Carlos, Luchi,Weverton Machado
Tipo de documento: Relatório
Idioma: eng
Título da fonte: Jornal Brasileiro de Nefrologia
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002018000400410
Resumo: ABSTRACT Hyperkalemic renal tubular acidosis is a non-anion gap metabolic acidosis that invariably indicates an abnormality in potassium, ammonium, and hydrogen ion secretion. In clinical practice, it is usually attributed to real or apparent hypoaldosteronism caused by diseases or drug toxicity. We describe a 54-year-old liver transplant patient that was admitted with flaccid muscle weakness associated with plasma potassium level of 9.25 mEq/L. Additional investigation revealed type 4 renal tubular acidosis and marked hypomagnesemia with high fractional excretion of magnesium. Relevant past medical history included a recent diagnosis of Paracoccidioidomycosis, a systemic fungal infection that is endemic in some parts of South America, and his outpatient medications contained trimethoprim-sulfamethoxazole, tacrolimus, and propranolol. In the present acid-base and electrolyte case study, we discuss a clinical approach for the diagnosis of hyperkalemic renal tubular acidosis and review the pathophysiology of this disorder.
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spelling A physiology-based approach to a patient with hyperkalemic renal tubular acidosisHyperkalemiaCalcineurinHypoaldosteronismAcidosis, Renal TubularMagnesiumABSTRACT Hyperkalemic renal tubular acidosis is a non-anion gap metabolic acidosis that invariably indicates an abnormality in potassium, ammonium, and hydrogen ion secretion. In clinical practice, it is usually attributed to real or apparent hypoaldosteronism caused by diseases or drug toxicity. We describe a 54-year-old liver transplant patient that was admitted with flaccid muscle weakness associated with plasma potassium level of 9.25 mEq/L. Additional investigation revealed type 4 renal tubular acidosis and marked hypomagnesemia with high fractional excretion of magnesium. Relevant past medical history included a recent diagnosis of Paracoccidioidomycosis, a systemic fungal infection that is endemic in some parts of South America, and his outpatient medications contained trimethoprim-sulfamethoxazole, tacrolimus, and propranolol. In the present acid-base and electrolyte case study, we discuss a clinical approach for the diagnosis of hyperkalemic renal tubular acidosis and review the pathophysiology of this disorder.Sociedade Brasileira de Nefrologia2018-12-01info:eu-repo/semantics/reportinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002018000400410Brazilian Journal of Nephrology v.40 n.4 2018reponame:Jornal Brasileiro de Nefrologiainstname:Sociedade Brasileira de Nefrologia (SBN)instacron:SBN10.1590/2175-8239-jbn-3821info:eu-repo/semantics/openAccessMenegussi,JulianaTatagiba,Luiza SarmentoVianna,Júlia Guasti P.Seguro,Antonio CarlosLuchi,Weverton Machadoeng2019-02-05T00:00:00Zoai:scielo:S0101-28002018000400410Revistahttp://www.bjn.org.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||jbn@sbn.org.br2175-82390101-2800opendoar:2019-02-05T00:00Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)false
dc.title.none.fl_str_mv A physiology-based approach to a patient with hyperkalemic renal tubular acidosis
title A physiology-based approach to a patient with hyperkalemic renal tubular acidosis
spellingShingle A physiology-based approach to a patient with hyperkalemic renal tubular acidosis
Menegussi,Juliana
Hyperkalemia
Calcineurin
Hypoaldosteronism
Acidosis, Renal Tubular
Magnesium
title_short A physiology-based approach to a patient with hyperkalemic renal tubular acidosis
title_full A physiology-based approach to a patient with hyperkalemic renal tubular acidosis
title_fullStr A physiology-based approach to a patient with hyperkalemic renal tubular acidosis
title_full_unstemmed A physiology-based approach to a patient with hyperkalemic renal tubular acidosis
title_sort A physiology-based approach to a patient with hyperkalemic renal tubular acidosis
author Menegussi,Juliana
author_facet Menegussi,Juliana
Tatagiba,Luiza Sarmento
Vianna,Júlia Guasti P.
Seguro,Antonio Carlos
Luchi,Weverton Machado
author_role author
author2 Tatagiba,Luiza Sarmento
Vianna,Júlia Guasti P.
Seguro,Antonio Carlos
Luchi,Weverton Machado
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Menegussi,Juliana
Tatagiba,Luiza Sarmento
Vianna,Júlia Guasti P.
Seguro,Antonio Carlos
Luchi,Weverton Machado
dc.subject.por.fl_str_mv Hyperkalemia
Calcineurin
Hypoaldosteronism
Acidosis, Renal Tubular
Magnesium
topic Hyperkalemia
Calcineurin
Hypoaldosteronism
Acidosis, Renal Tubular
Magnesium
description ABSTRACT Hyperkalemic renal tubular acidosis is a non-anion gap metabolic acidosis that invariably indicates an abnormality in potassium, ammonium, and hydrogen ion secretion. In clinical practice, it is usually attributed to real or apparent hypoaldosteronism caused by diseases or drug toxicity. We describe a 54-year-old liver transplant patient that was admitted with flaccid muscle weakness associated with plasma potassium level of 9.25 mEq/L. Additional investigation revealed type 4 renal tubular acidosis and marked hypomagnesemia with high fractional excretion of magnesium. Relevant past medical history included a recent diagnosis of Paracoccidioidomycosis, a systemic fungal infection that is endemic in some parts of South America, and his outpatient medications contained trimethoprim-sulfamethoxazole, tacrolimus, and propranolol. In the present acid-base and electrolyte case study, we discuss a clinical approach for the diagnosis of hyperkalemic renal tubular acidosis and review the pathophysiology of this disorder.
publishDate 2018
dc.date.none.fl_str_mv 2018-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/report
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format report
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002018000400410
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002018000400410
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/2175-8239-jbn-3821
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
dc.source.none.fl_str_mv Brazilian Journal of Nephrology v.40 n.4 2018
reponame:Jornal Brasileiro de Nefrologia
instname:Sociedade Brasileira de Nefrologia (SBN)
instacron:SBN
instname_str Sociedade Brasileira de Nefrologia (SBN)
instacron_str SBN
institution SBN
reponame_str Jornal Brasileiro de Nefrologia
collection Jornal Brasileiro de Nefrologia
repository.name.fl_str_mv Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)
repository.mail.fl_str_mv ||jbn@sbn.org.br
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