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Life-threatening reversible acidosis caused by alcohol abuse

Nature Reviews Nephrology volume 6, pages 555–559 (2010)Cite this article

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Abstract

Background. A 52-year-old man with a history of alcohol dependency was admitted to the emergency room with life-threatening anion gap metabolic acidosis. He admitted to drinking large quantities of alcohol during the previous day.

Investigations. Physical examination, blood and urine analyses, including calculation of his anion gap and plasma osmolal gap, and measurement of serum alcohol levels.

Diagnosis. Severe but rapidly reversible lactic acidosis and associated alcohol-induced ketoacidosis.

Management. Intravenous thiamine, intravenous fluids and bicarbonate.

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Figure 1: Time course of arterial pH values for the first 12 h after admission to the emergency room.
Figure 2: Time course of laboratory values of acid–base parameters for the first 12 h after admission to the emergency room.
Figure 3: The metabolic pathways of ethanol and its role in lactate production.

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Acknowledgements

We wish to thank our clinical dietician, Ms Bathsheva Engel, Department of Nephrology & Hypertension, Kaplan Medical Center, Rehovot, Israel, for performing the dietary analysis.

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Authors and Affiliations

  1. Department of Nephrology & Hypertension, Kaplan Medical Center, PO Box 1, Rehovot, 76100, Israel

    Philip D. Shull & Jayson Rapoport

  2. Faculty of Medicine, Hebrew University, Jerusalem, Israel

    Jayson Rapoport

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  1. Philip D. Shull
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P. D. Shull and J. Rapoport contributed equally to researching data for the article, discussing content, writing, and reviewing/editing the manuscript before submission.

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Correspondence to Jayson Rapoport.

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The authors declare no competing financial interests.

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Shull, P., Rapoport, J. Life-threatening reversible acidosis caused by alcohol abuse. Nat Rev Nephrol 6, 555–559 (2010). https://doi.org/10.1038/nrneph.2010.99

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