Hypokalemia-Induced Cardiac Arrest

Area of Science:

• Nephrology
• Internal Medicine
• Cardiology

Background:

• Renal tubular acidosis (RTA) encompasses disorders impairing kidney hydrogen ion excretion or bicarbonate reabsorption, causing metabolic acidosis.
• Hypokalemia is a common feature across various RTA types.

Observation:

• A chronic alcoholic patient presented with severe hypokalemia and experienced multiple cardiac arrests.
• Despite potassium supplementation, cardiac events persisted, indicating a complex underlying cause.

Findings:

• Diagnosis of distal RTA was established through hyperchloremic metabolic acidosis, low serum bicarbonate, hypokalemia, normal renal function, alkaline urine, and a positive urinary anion gap.
• Chronic alcohol abuse was identified as the likely etiology for type 1 RTA in this patient.

Implications:

• This case underscores the critical link between chronic alcohol abuse and distal RTA.
• Recognizing RTA is vital for managing severe hypokalemia and preventing life-threatening complications like cardiac arrest.