Acute Kidney Injury with Severe Metabolic Alkalosis Caused by Habitual Vomiting in an Alcohol Abuser with Pyloric Stenosis

Kota Kakeshita, Teruhiko Imamura*, Tsutomu Koike, Hayato Fujioka, Taigo Kiyosawa, Ayako Shimizu, Hidenori Yamazaki, Koichiro Kinugawa

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

A 47-year-old man was complaining of consciousness disorder. He had acute kidney injury, hypokalemia, and severe metabolic alkalosis. Initial treatment using intravenous infusion of 0.9% saline and potassium chloride improved his consciousness. It was clarified that he was a severe alcohol abuser who habitually self-vomited. We diagnosed him with volume depletion and pseudo-Bartter’s syndrome due to loss of chloride by habitual vomiting. Gastrointestinal endoscopy demonstrated pyloric stenosis, which was ameliorated by Helicobacter pylori eradication therapy. We should consider volume depletion and pseudo-Bartter’s syndrome as differential diagnoses when we encounter patients with acute kidney injury and severe metabolic alkalosis.

Original languageEnglish
Pages (from-to)1031-1035
Number of pages5
JournalInternal Medicine
Volume62
Issue number7
DOIs
StatePublished - 2023

Keywords

  • gastric pyloric stenosis
  • hypokalemia
  • myopathy
  • pseudo-Bartter’s syndrome
  • secondary hyperaldosteronism

ASJC Scopus subject areas

  • Internal Medicine

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