Atypical electrolyte kinetics during an emergency dialysis session in a patient with Leriche syndrome
Koball, S.; Hickstein, H.; Führer, A.; Heller, T.; Stange, J.; Mitzner, S.
Clinical Nephrology 74(6): 471-473
2010
ISSN/ISBN: 0301-0430 PMID: 21084051 Document Number: 640735
A hemodialysis patient suffered from circulation failure due to a low output syndrome caused by a hyperkalemia (9.9 micromol/l) with typical ecg signs. An emergency hemodialysis was started. After 2 h ecg signs of hypokalemia (2.1 micromol/l) were detectable. Hemodialysis was stopped. 2 h later, serum potassium rose to 6.2 micromol/l. An obturation of the aorta and the inferior caval vein with perfusion through collateral vessels of the lower body side was obvious, resulting into a faster electrolyte correction in the upper and a delayed correction in the lower body side with a rebound in the upper compartment. Dialysis time and dialysate potassium (4.0 micromol/l) were increased. Furthermore no potassium problems occurred.