Rhabdomyolysis can be defined as a clinical syndrome associated with the breakdown of skeletal muscle fibres and myocyte cell membranes, leading to release of muscle contents into the circulation, resulting in multiple complications, including hyperkalaemia. It is a medical emergency and can lead to cardiac arrest if not promptly treated. Myoglobinuria is an early feature of rhabdomyolysis, but...

Sodium or calcium polystyrene sulfonate (Kayexalate or analog) is an ion-exchange resin commonly used to treat hyperkalaemia in patients with chronic kidney disease. It is known to cause digestive complications, such as nausea, vomiting and constipation. Although rare, colonic necrosis and perforation are very severe complications associated with the medication. In this case report, we present ...

Clinical Problem A 73 year old female patient presented to the Accident and Emergency Department (A&E) with a profound anaemia, acute kidney injury (AKI) and severe hyperkalaemia. She had a background of Chronic Obstructive Pulmonary Disease (COPD), osteoarthritis, hypertension, morbid obesity and a very poor functional status. She described a one week history of bleeding haemorrhoids. She was ...

Diabetic ketoacidosis (DKA) is an acute, life-threatening metabolic complication of diabetes mellitus. Hyperglycaemia, ketosis (ketonaemia or ketonuria) and acidosis are the cardinal features of DKA [1]. Other features that indicate the severity of DKA include volume depletion, acidosis and concurrent electrolyte disturbances, especially abnormalities of potassium homeostasis [1,2]. We describe...

Rhabdomyolysis can be defined as a clinical syndrome associated with the breakdown of skeletal muscle fibres and myocyte cell membranes, leading to release of muscle contents into the circulation, resulting in multiple complications, including hyperkalaemia. It is a medical emergency and can lead to cardiac arrest if not promptly treated. Myoglobinuria is an early feature of rhabdomyolysis, but...

In patients with chronic heart failure, spironolactone added to conventional treatment may lead to serious and, occasionally, fatal hyperkalaemia. In some cases this seems to happen because spironolactone causes diarrhoea. Four cases involving men with New York Heart Association functional class III heart failure are presented. As these cases revealed, close monitoring of blood chemistry is man...

Thirty neonates with acute renal failure were studied, 27 of whom died (90%) including nine of 12 treated by peritoneal dialysis. Three main aetiological groups were identified. Septicaemia was a principal cause of late onset acute renal failure, with an incidence equal to that of serious perinatal disorders. It is recommended that tolazoline should be used with caution in the treatment of hype...

Cardiac arrest occurred in a 5 1/2-year-old child with suspected Duchenne's muscular dystrophy ten minutes following induction of anaesthesia with halothane, nitrous oxide and oxygen. No muscle relaxants were administered. The cardiac arrest was associated with hyperkalaemia, acidosis, myoglobinuria, elevated serum creatine phosphokinase and a 1.6 degrees C rise in temperature. The child made a...