Odhiambo John, Patel Hanika, Mutuiri Anderson, Yakub Fazal, Sokwala Ahmed
Internal Medicine, The Aga Khan University Hospital, Nairobi, Kenya.
Radiology, The Aga Khan University Hospital, Nairobi, Kenya.
Case Rep Nephrol. 2022 Jul 19;2022:6284693. doi: 10.1155/2022/6284693. eCollection 2022.
This was a case of a 39-year-old gentleman known to have diabetes mellitus since February 2021 on insulin glargine (Lantus) 16 units nocte and sitagliptin/metformin 50/500 mg once a day who presented to a tertiary teaching hospital in Kenya in May 2021 with a three-week history of vomiting and diarrhea. He had been previously admitted to a different facility with acute alcoholic pancreatitis. His examination was nonremarkable except for mild dehydration and pallor. He had moderate metabolic acidosis and deranged renal function. Prior to this, his creatinine was normal. As part of the evaluation for the rapid deterioration of renal function, a kidney biopsy performed revealed oxalate nephropathy. He was started on renal replacement therapy with hemodialysis.
这是一例39岁男性患者,自2021年2月起确诊为糖尿病,每晚皮下注射甘精胰岛素(来得时)16单位,每日口服西格列汀/二甲双胍50/500毫克。2021年5月,他因持续三周的呕吐和腹泻症状就诊于肯尼亚一家三级教学医院。他曾因急性酒精性胰腺炎入住另一家医疗机构。除轻度脱水和面色苍白外,体格检查无明显异常。患者存在中度代谢性酸中毒及肾功能紊乱,此前其肌酐水平正常。作为评估肾功能快速恶化原因的一部分,肾脏活检显示为草酸盐肾病。随后他开始接受血液透析的肾脏替代治疗。