Musso Carlos G, Luque Karina, Schreck Carlos, Imperiali Nora, Algarnati Luis
Nephrology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Int Urol Nephrol. 2007;39(2):661-3. doi: 10.1007/s11255-007-9195-9.
Hyperkalemia is an unusual complication in peritoneal dialysis patients, having a prevalence of around 0.8% among the continuous ambulatory peritoneal dialysis (CAPD) population. The main cause of hyperkalemia in this group is the release of potassium from sources such as gross haematomas and rhabdomyolysis. However, there is no previous report regarding hyperkalemia induced by intracellular potassium shift into the intravascular compartment secondary to drug-induced acute hepatitis in peritoneal dialysis. We present the following case report of a peritoneal dialysis patient, well dialyzed and on a low-potassium diet, who was admitted in our hospital with paralysis secondary to hyperkalemia (serum potassium: 7 mmol/l). Both disorders disappeared using continuous automated peritoneal dialysis (APD) until liver enzymes normalized. We concluded that acute hepatitis can be a cause of hyperkalemia in a properly nourished and well-dialyzed peritoneal dialysis patient.
高钾血症是腹膜透析患者中一种不常见的并发症,在持续性非卧床腹膜透析(CAPD)人群中的患病率约为0.8%。该组患者高钾血症的主要原因是钾从诸如大面积血肿和横纹肌溶解等来源释放。然而,此前尚无关于腹膜透析患者因药物性急性肝炎继发细胞内钾转移至血管内间隙而导致高钾血症的报道。我们报告如下病例:一名腹膜透析患者,透析充分且饮食低钾,因高钾血症(血清钾:7 mmol/L)继发麻痹入院。采用持续自动化腹膜透析(APD)治疗后,两种病症均消失,直至肝酶恢复正常。我们得出结论,在营养良好且透析充分的腹膜透析患者中,急性肝炎可能是高钾血症的一个病因。