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정위 인공방광대체술 및 방광확대술 후 발생한 심한 고염소혈증 대사성 산증 2예
이한규 ( Han Kyu Lee ),선휘경 ( Hui Kyuoung Sun ),김동기 ( Dong Ki Kim ),오국환 ( Kook Hwan Oh ),김연수 ( Yon Su Kim ),안규리 ( Cu Rie Ahn ),한진석 ( Jin Suk Han ),김성권 ( Sunhn Gwon Kim ),곽철 ( Cheol Kwak ),오승준 ( Seung June 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.5
The use of intestinal segments in the reconstruction and plasty of urinary bladder for malignant or nonmalignant conditions is widely accepted. Metabolic derangements including hyperchloremic metabolic acidosis and malabsorption of lipid may occur after surgery. Main pathophysiology of hyperchloremic metabolic acidosis is the exchange of urinary chloride with luminal bicarbonate and duration of urine in contact with the intestinal mucosa can affect the severity of metabolic acidosis. We experienced two cases of severe hyperchloremic metabolic acidosis which developed in patients with chronic kidney disease, urinary tract infection and orthotopic neobladder or augmentation enterocystoplasty for the treatment of bladder cancer and neurogenic bladder, respectively.