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Extreme hyperkalaemia secondary to malignant ureteric obstruction: case report
Y Ali1, R K Gupta, E O Kehinde
1Department of Surgery, Division of Urology, Kuwait University, Kuwait, P.O Box 24923,13110, Safat, Kuwait.
East African Medical Journal
|April 26, 2007
Summary
A patient with advanced bladder cancer experienced severe renal failure with life-threatening potassium levels. Prompt treatment with hemodialysis and nephrostomy tubes led to a slow but significant recovery.
Area of Science:
- Nephrology
- Oncology
- Urology
Background:
- Obstructive uropathy is a common cause of acute kidney injury.
- Advanced bladder cancer can lead to severe complications, including renal failure.
Observation:
- A 42-year-old male presented with collapse due to acute-on-chronic renal failure.
- Biochemical analysis revealed hyperkalemia (10.3 mmol/L), elevated creatinine (3581 pmol/L), and urea (59.9 mmol/L).
- The renal failure was secondary to obstructive uropathy from advanced bladder cancer.
Findings:
- Despite biochemical derangements considered incompatible with life, the patient showed a slow recovery.
- Treatment involved emergent hemodialysis and bilateral percutaneous nephrostomy tube insertion.
Implications:
- This case highlights the potential for recovery even in severe renal failure due to malignancy.
- Aggressive management, including renal replacement therapy and urinary diversion, can be life-saving.
- Early recognition and intervention are crucial for managing obstructive uropathy in advanced cancer patients.
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