Metabolic Alkalosis in a Hemodialysis Patient After Ingestion of a Large Amount of an Antacid Medication

Sahani, Mandeep; Brennan, John F.; Nwakanma, Chukwuemeka; Chow, May T.; Ing, Todd S.; Leehey, David J.

doi:10.1046/j.1525-1594.2001.06714.x

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…Metabolic acidosis is a common finding in chronic kidney disease ( 4 ). Though less common in patients with end-stage renal disease undergoing hemodialysis, there were 2 reported cases of metabolic alkalosis attributed to oral baking soda intake ( 9 , 10 ).…”

Section: Discussionmentioning

confidence: 99%

Metabolic alkalosis‑an adverse effect of baking soda misuse: A case report and literature review

Diaconu¹,

Florea

Vlad

et al. 2022

Exp Ther Med

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Baking soda overdose is rarely reported. However, several cases have been previously documented, as baking soda has gained popularity as an over-the-counter remedy. The present study reported the case of a 69-year-old male patient hospitalized with metabolic alkalosis (pH 7.61; bicarbonate levels, 53.2 mEq/l), hypokalemia (K + 2.6 mEq/l), acute kidney injury (serum creatinine level 4.02 mg/dl) and hepatic toxicity (alanine transaminase, 955 U/l; aspartate transaminase, 1,091 U/l) in the context of baking soda misuse as an alternative treatment for gout. The patient's past medical history included chronic uric acid nephropathy, gout, arterial hypertension and permanent atrial fibrillation. Under corrective treatment for the hydro-electrolyte and acid-base imbalances, the hepatic injury and inflammation markers were within normal limits; uric acid and creatinine serum levels also decreased.

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Section: Discussionmentioning

confidence: 99%

Metabolic alkalosis‑an adverse effect of baking soda misuse: A case report and literature review

Diaconu¹,

Florea

Vlad

et al. 2022

Exp Ther Med

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“…Despite modifications in dialysate over the past decade, uremic patients under HD have low serum HCO 3 À and pH pre-HD. [5,7,10] It is suggested by some reports that, in uremic patients, the ABS% pre-HD must be about 53.2% of total BW and the serum HCO 3 À about 20 mEq/L, whereas in normal subjects the higher level of ABS% is 50% BW (kg). [4,6,8,9] The correction of acidosis in these patients is achieved by the direct transfer of HCO 3 À from dialysate solution to blood during HD session.…”

Section: Discussionmentioning

confidence: 99%

Relation of Interdialytic Water Retention with Apparent Bicarbonate Space, HCO3-, and pH in Hemodialyzed Uremic Patients

Tzanatos¹,

Dalamangas²,

Retsa³

et al. 2005

LRNF

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This study determines the relationship between interdialytic water retention (IWR) and acid-base homeostasis in uremic patients under regular hemodialysis (HD). To this aim, in 33 regular bicarbonate HD sessions of 11 uremic patients (three HD sessions of 1 week for each patient), blood samples were received from arterial line immediately pre- and post-HD anaerobically in heparinized syringes and the HCO3-, pH, and pco2 were determined. Also in the studied HD sessions, the IWR was estimated and the apparent bicarbonate space percentage (ABS%) pre- and post-HD was calculated by Fernandez et al. (Eq. 1). The mean +/- SD values pre-HD (ABS% = 54.15 +/- 1.49, HCO3- = 18.54 +/- 2.0 mmol/L, pH = 7.32 +/- 0.02, pco2 = 35.44 +/- 3.10 mmHg) and post-HD (ABS% = 49.88 +/- 0.6, HCO3- = 26.33 +/- 1.6 mmol/L, pH = 7.44 +/- 0.02, pco2 = 37.69 +/- 3.00 mmHg) show metabolic acidosis pre-HD and slight alkalosis post-HD. There was a significant positive correlation between IWR and ABS% pre-HD (r = 0.650, p < .0001) and post-HD (r = 0.655, p < .0001), but a significant negative correlation between IWR and HCO3- pre-HD (r = -0.502, p < .003) and post-HD (r = -0.700, p < .001), as well as between IWR and pH pre-HD (r = -0.516, p < .002) and post-HD (r = -0.377, p < .03). In addition, there was a significantly negative correlation between IWR and pco2 post-HD (r = -0.656, p < .001), but not pre-HD (r = 0.0136, PNS). The significantly positive relationship between IWR and ABS% pre- and post-HD, in combination with the significantly negative correlation between HCO3- and pH pre- and post-HD, indicates that the IWR negatively influences the acid-base homeostasis in hemodialysis patients without residual renal function, and may worsen the cardiovascular physiology and tissue oxygenation of these patients.

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Baking soda induced severe metabolic alkalosis in a haemodialysis patient

Solak

Türkmen

Atalay

et al. 2009

Clinical Kidney Journal

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Metabolic alkalosis is a rare occurence in hemodialysis population compared to metabolic acidosis unless some precipitating factors such as nasogastric suction, vomiting and alkali ingestion or infusion are present. When metabolic alkalosis develops, it may cause serious clinical consequences among them are sleep apnea, resistent hypertension, dysrhythmia and seizures. Here, we present a 54-year-old female hemodialysis patient who developed a severe metabolic alkalosis due to baking soda ingestion to relieve dyspepsia. She had sleep apnea, volume overload and uncontrolled hypertension due to metabolic alkalosis. Metabolic alkalosis was corrected and the patient's clinical condition was relieved with negative-bicarbonate hemodialysis

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Metabolic Alkalosis in a Hemodialysis Patient After Ingestion of a Large Amount of an Antacid Medication

Cited by 3 publications

References 8 publications

Metabolic alkalosis‑an adverse effect of baking soda misuse: A case report and literature review

Metabolic alkalosis‑an adverse effect of baking soda misuse: A case report and literature review

Relation of Interdialytic Water Retention with Apparent Bicarbonate Space, HCO3-, and pH in Hemodialyzed Uremic Patients

Baking soda induced severe metabolic alkalosis in a haemodialysis patient

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