Hypokalemic paralysis associated with cystic disease of the kidney: case report

Champika Sssk Gamakaranage,Chaturaka Rodrigo,Saroj Jayasinghe,Senaka Rajapakse

doi:10.1186/1471-2369-12-16

Champika Sssk Gamakaranage, Chaturaka Rodrigo + Show 2 more

Open Access

https://doi.org/10.1186/1471-2369-12-16

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Abstract

BackgroundSevere hypokalemia is known to cause muscle paralysis, and renal tubular acidosis is a recognized cause. Cystic disease of the kidney is associated with severe hypokalemia.Case presentationWe report a 33-year-old male patient who presented with generalized limb weakness caused by severe hypokalemia due to renal tubular acidosis, who was found to have renal medullary cysts.ConclusionThe association of cystic renal disease with hypokalemia, and the possible pathophysiological basis of the development of renal cysts in patients with severe hypokalemia, are discussed.

Highlights

Severe hypokalemia is known to result in muscle paralysis [1], and renal tubular acidosis (RTA) is a recognized cause [2,3]
We report a patient who presented with severe hypokalemia due to renal tubular acidosis who was found to have cystic renal disease, and discuss the possible pathogenesis of cyst formation in the kidney
Cystic disease of the kidney has long been associated with hypokalemia and sometimes with renal tubular acidosis

Summary

Background

Severe hypokalemia is known to result in muscle paralysis [1], and renal tubular acidosis (RTA) is a recognized cause [2,3]. At the time of peak paralysis, the arterial blood gas showed a pH of 7.45 (7.35-7.45), pCO2 of 22.4 mmHg (36-44), pO2 of 129 mmHg (80-100), Oxygen saturation of 99%, Bicarbonate of 15.6 mmol/l (22-28), and a base excess of (-)8.6 mEq/l This picture was suggestive of a compensated metabolic acidosis. The creatine kinase level in this patient was high (initially 704 IU/l and increased to 1262 IU/L subsequently, reference range: 60-300) probably due to rhabdomyolysis associated with hypokalemia and RTA [5,7], this did not result in acute kidney injury (AKI). Chronic active hepatitis is known to be associated with renal tubular acidosis and hypokalemia [8]

Conclusions

10. Yendt ER

17. Grantham JJ