Erschienen in:
11.03.2022 | Clinical Quiz
Metabolic alkalosis in peritoneal dialysis — beyond the obvious: Questions
verfasst von:
Neha Sharma, Abdulla M. Ehlayel
Erschienen in:
Pediatric Nephrology
|
Ausgabe 9/2022
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Excerpt
A 15-year-old African American male with a history of stage 5 chronic kidney disease secondary to focal segmental glomerulosclerosis (FSGS) and bilateral nephrectomy on peritoneal dialysis (PD) presented with a generalized tonic–clonic seizure. He was evaluated in the emergency room where his vitals showed a heart rate of 105, blood pressure of 142/104 mmHg, temperature of 37.6 °C, and O2 saturation of 89%. On exam, he was agitated, confused, and oriented only to person and place. His neurologic examination was otherwise normal. Initial labs showed sodium 152 mmol/L (normal 136–145), potassium 3.7 mmol/L (normal 3.5–5.1), CO2 > 44 mmol/L (normal 22–33), and chloride 77 mmol/L (normal 98–107). Arterial blood gas showed pH 7.64 (normal 7.35–7.45), CO2 concentration of 60.6 mmHg (normal 35–45), HCO3 67.7 mmol/L, and base excess of 38.5 mmol/L (normal − 2 to 2). After additional investigation, he was diagnosed with encephalitis due to COVID-19 infection. …
