North American Journal of Medical Sciences

CASE REPORT
Year
: 2014  |  Volume : 6  |  Issue : 12  |  Page : 648--649

Crohnic kidney disease: Recurrent acute kidney failure in a patient with Crohn's disease


Mehmet Emin Demir1, Zafer Ercan2, Emel Yigit Karakas3, Turgay Ulas3, Hakan Buyukhatipoglu3,  
1 Department of Internal Medicine, School of Medicine; Division of Nephrology, Harran University, Sanliurfa, Turkey
2 Department of Internal Medicine, Division of Nephrology, Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
3 Department of Internal Medicine, School of Medicine, Harran University, Sanliurfa, Turkey

Correspondence Address:
Turgay Ulas
Department of Internal Medicine, Harran University School of Medicine, Yenisehir Campus, 63000, Sanliurfa
Turkey

Abstract

Context: Short bowel syndrome is a rare and devastating complication in chronic inflammatory bowel disease following functional or anatomic loss of extensive segments of the intestine. Case Report: A 60-year-old male patient with Crohn«SQ»s disease had undergone multiple resections of the intestine and developed short bowel syndrome. Despite up to 4-5 liters of orally fluid, sufficient calcium and magnesium intake, he suffered from recurrent acute kidney injury due to profound volume depletion and those electrolyte deficiencies. Administration of intravenous fluid and electrolyte repleacement treatment at regular intervals prevented further kidney injuries. Conclusion: We present a case of recurrent acute kidney failure in a patient with Crohn«SQ»s disease, and aimed to remark importance of receiving sufficient parenteral fluid and electrolyte support in those with short bowel syndrome.



How to cite this article:
Demir ME, Ercan Z, Karakas EY, Ulas T, Buyukhatipoglu H. Crohnic kidney disease: Recurrent acute kidney failure in a patient with Crohn's disease.North Am J Med Sci 2014;6:648-649


How to cite this URL:
Demir ME, Ercan Z, Karakas EY, Ulas T, Buyukhatipoglu H. Crohnic kidney disease: Recurrent acute kidney failure in a patient with Crohn's disease. North Am J Med Sci [serial online] 2014 [cited 2019 Dec 10 ];6:648-649
Available from: http://www.najms.org/text.asp?2014/6/12/648/147983


Full Text

 Introduction



Crohn's disease have unfavorable effects on kidney functions due to malabsorption and dehydration such as acute kidney failure, calcium oxalate-uric acide stones and electrolyte abnormalities. [1],[2],[3] Impaired water, Na + , and Cl - absorption in the diseased colon are the main fluid and electrolyte transport abnormailities in Crohn's disease. [4] Besides, hypomagnesemia and hypocalcemia are common disorders encountered in Crohn's disease. Both, the diseased colon and short bowel syndrome, consquence of multiple intestinal resection, can result in recurrent acute kidney failure and electrolyte imbalance in Crohn's disease.

 Case Presentation



We present a 60-year-old male patient with Crohns disease who came to our emergency department complaining of headache, nausea, vomiting and muscle weakness. He was diagnosed with pre-renal acute on chronic kidney failure, hyponatremia, hypomagnesemia and hypocalcemia as has been diagnosed many times in his past medical history. He was in remission for Crohn's disease but had developed short bowel syndrome because of multiple intestinal resection. Kidney function and electrolyte deficiency improved with fluid and electrolyte replacement in a short course of hospitalization. Administration of intravenous fluid and electrolyte repleacement treatment at regular intervals prevented further kidney injuries and occurrence of symptomatic electrolyte disordres.

 Conclusion



Clinicians offen encounter with deterioration in kidney function and electrolyte deficiency in the course of the Crohn's disease. Acute kidney failure, hydronephrosis and rarely amyloidosis due to dehydration, obstruction of ureter caused by inflamed intestine and abnormal protein deposition, respectevily, are some of those clinic problems. Besides, numerous electrolyte deficiency including hyponatremia, hypomagnesemia, and hypocalcemia have been declared. We aim to remark for clinicians to be in an attempt for the sufficient support of fluid and electrolyte in Crohn's disease, especially in patients with multipl segmental intestinal resection.

References

1Hueppelshaeuser R, von Unruh GE, Habbiq S, Beck BB, Buderus S, Hesse A, et al. Eneteric hyperoxaluria, recurrent urolithiasis, and systemic oxalasis in patients with Crohn's disease. Pediatr Nephrol 2012;27:1103-9.
2Jacobi J, Schnellhardt S, Opgenoorth M, Amman KU, Küttner A, Schmid A, et al. Severe metabolic alkalosis and recurrent acute on chronic kidney injury in a patient with Crohn's disease. BMC Nephrol 2010;11:6.
3DiBaise JK, Young RJ, Vanderhoof JA. Intestinal rehabilitation and the short bowel syndrome: Part 1.Am J Gastroenterol. 2004;99:1386-95.
4Binder HJ, Sandle GI, Rajendran VM. Colonic fluid and electrolyte transport in health and disease. In: Philips SF, Pemberton JH, Shorter RG, editors. The large intestine: Physiology, pathophysiology, and disease. New York: Raven Press; 1991. p. 141-68.