Acid-base and electrolyte disorders after urinary diversion

The use of bowel in urologic reconstructive procedures may result in numerous short and long-term complications, including well-described acid-base and electrolyte disorders. Many of these metabolic alterations are influenced by how solute absorption occurs across the particular bowel segment chosen for reconstruction. Solute absorption is impacted by: (1) the segment of bowel used, (2) the surface area of bowel used, (3) the time of retention of urine, (4) the concentration of solutes in the urine, (5) renal function, and (6) the pH and osmolality of the urine. These factors affect the type and amount of solutes absorbed, as well as the severity of metabolic complications that develop.