Rana Abdul Mughees, Mansoor Kannan, Assad Salman, Abouzid Mahmoud, Ogu Iheanyichukwu, Bandak Ghassan Salim Issa
Department of Internal Medicine University Huntington, 1249 15th Street Suite 2000, Huntington, WV 25514, USA.
Department of Neurology Marshall University Joan C. Edwards School of Medicine, 1600 Medical Center Drive Office B561, Huntington, WV, USA.
Case Rep Nephrol. 2020 Sep 15;2020:8861978. doi: 10.1155/2020/8861978. eCollection 2020.
Obesity is an epidemic with high burden of disease. It is directly proportional to increased risk of morbidity and mortality. Ketogenic diet and herbal supplements have recently gained popularity amongst patients struggling with weight loss. There are limited data available for most of these supplements contrary to the claims laid by the mainstream media. Due to lack of awareness, this patient population is at high risk of adverse effects. We present a case of severe acidosis secondary to ketogenic diet and acetic acid (vinegar) ingestion. The use of dietary acetic acid is usually well tolerated; however, in this case, the large quantities and presence of acute renal injury may have worsened the acidosis. Severe ketosis in setting of ketogenic diets is a serious complication, which is infrequently reported in literature. Many of these diets and supplements may seem harmless, but as our case illustrates, when combined with other risk factors, patients can face adverse effects and even hospitalization. It is imperative that such dietary practices are physician supervised to avoid complications. With the recent surge of over-the-counter weight loss supplements and fat diets, physicians need to engage in dietary discussion with patients when attempting to lose weight.
肥胖是一种疾病负担沉重的流行病。它与发病率和死亡率的增加成正比。生酮饮食和草药补充剂最近在减肥困难的患者中颇受欢迎。与主流媒体的说法相反，大多数这些补充剂的可用数据有限。由于缺乏认识，这一患者群体面临着不良反应的高风险。我们报告一例因生酮饮食和摄入醋酸（醋）继发严重酸中毒的病例。食用膳食醋酸通常耐受性良好；然而，在本例中，大量摄入以及急性肾损伤的存在可能使酸中毒恶化。生酮饮食情况下的严重酮症是一种严重并发症，在文献中鲜有报道。许多这类饮食和补充剂看似无害，但正如我们的病例所示，当与其他风险因素结合时，患者可能面临不良反应甚至住院治疗。必须由医生监督此类饮食习惯以避免并发症。随着最近非处方减肥补充剂和脂肪饮食的激增，医生在患者试图减肥时需要与他们进行饮食方面的讨论。
