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Chronic acidosis with metabolic bone disease.
The New Zealand Medical Journal
|June 26, 1985
Summary
A woman developed chronic acidosis and osteomalacia after ureter implantation into the rectum. Recommencing sodium bicarbonate treatment rapidly improved her osteomalacia, highlighting its role in managing metabolic acidosis complications.
Area of Science:
- Nephrology
- Urology
- Endocrinology
Background:
- Ureter implantation into the rectum can lead to chronic metabolic acidosis.
- Hyperchloremic acidosis, particularly in the context of normal renal function, poses risks for bone health.
Observation:
- A patient developed severe osteomalacia 4 years after discontinuing sodium bicarbonate therapy for chronic hyperchloremic acidosis.
- The acidosis was a consequence of ureterorectal implantation, a surgical procedure.
Findings:
- Clinical, biochemical, radiological, and radionuclide evidence confirmed osteomalacia.
- Treatment with sodium bicarbonate led to rapid improvement of the osteomalacia.
Implications:
- This case underscores the link between chronic metabolic acidosis and osteomalacia in patients with surgically altered urinary pathways.
- Maintaining adequate alkali therapy is crucial for preventing or managing bone disease in such cases.
- Highlights the importance of long-term monitoring for metabolic complications after ureterorectal implantation.