Lawson Christy, Morris Leisa, Wilson Vera, Burns Bracken
Surgery, Quillen College of Medicine, East Tennesse State University, Johnson City, USA.
Trauma, Ballad Health Trauma Services, Johnson City, USA.
Cureus. 2020 Aug 29;12(8):e10107. doi: 10.7759/cureus.10107.
Acetazolamide (ACZ) is a relatively commonly used medication in critical illness, glaucoma and altitude sickness. ACZ is sometimes used in the intensive care unit to assist with the treatment of metabolic alkalosis in ventilated patients. This is a case report of a patient who received two doses of ACZ, one week apart, for metabolic alkalosis and subsequently developed renal colic and dysuria that progressed to hemorrhagic anuria and acute kidney injury. This is an incredibly rare side effect of ACZ therapy, and has been reported in a few case reports in the literature, but usually is associated with a longer duration of therapy. This case resolved entirely within 24 hours with aggressive fluid therapy. Clinicians using ACZ therapy for any reason should be aware of this rare but significant side effect.
乙酰唑胺（ACZ）是危重病、青光眼和高原病中相对常用的药物。ACZ有时在重症监护病房用于协助治疗机械通气患者的代谢性碱中毒。本文报告一例患者，因代谢性碱中毒接受了两剂ACZ，间隔一周，随后出现肾绞痛和排尿困难，进而发展为出血性无尿和急性肾损伤。这是ACZ治疗极其罕见的副作用，文献中有少数病例报告，但通常与较长疗程相关。该病例通过积极的液体治疗在24小时内完全缓解。因任何原因使用ACZ治疗的临床医生应意识到这种罕见但严重的副作用。
