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KMID : 0882420090760060764
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Korean Journal of Medicine
2009 Volume.76 No. 6 p.764 ~ p.768
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A case of severe metabolic acidosis after orthotopic neobladder replacement
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Hong Sung-Ho
Lee Dong-Hun
Lee Young-Ki
Kim Jin-Kyung
Noh Jung-Woo
Oh Sook-Eui
Ahn Byung-Moo
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Abstract
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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).
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KEYWORD
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Acidosis, Urinary bladder, Bicarbonates
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