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Updated: Jul 10, 2025

Generation and On-Demand Initiation of Acute Ictal Activity in Rodent and Human Tissue
Published on: January 19, 2019
Hypernatremic chloride-depletion metabolic alkalosis successfully treated with high cation-gap amino acids: a case
Akihiro Ryuge1, Shogo Nagamine2, Masashi Saito3
1Department of Nephrology, National Hospital Organization Nagoya Medical Center, 1-1 Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan. ryuge0120@yahoo.co.jp.
Abstract:
Normal saline (NS) is recommended for the treatment of chloride-depletion alkalosis (CDA). However, its use in patients with drinking water restrictions or fluid volume deficiencies may lead to hypernatremia. We report the case of a 42-year-old Japanese man with ileus due to sigmoidal volvulus, who presented with CDA. After endoscopic decompression, NS was administered to treat the CDA. Despite the administration of NS, CDA persisted and hypernatremia developed. The infusion was then changed to high cation-gap amino acids (HCG-AA), which improved both metabolic alkalosis and hypernatremia. Thus, HCG-AA may be useful for the treatment of hypernatremia in patients with CDA.
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