A big thanks to @myadla.bsky.social @dramiliflores.bsky.social @dilushiwijay.bsky.social @kajareeg.bsky.social @theisn.org @nephroseeker.medsky.social
Thanks to the wonderful #NephSky community for tuning in!

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A glimpse at the causes of an Acquired Bartter Defect too! #ECNeph

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How do we manage Ogilvie’s syndrome?

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❓ What is this Acute Pseudo colonic Obstruction (Ogilvie’s syndrome)?

👉 Several theories have been proposed

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👉 In vitro studies suggest that colonic Maxi – K channels are upregulated

👉 These are the same channels upregulated in CKD, enhancing gut excretion of potassium

👉 In ESRD, the colonic excretion of Potassium is 3-fold that of normal individuals
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Here are some of the case reports describing hypokalemia in Ogilvie’s syndrome

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Several confounders in this case

Investigations will be confusing when the case is evolving

Better to hold on to your horses 🐴 and wait till the patient settles

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Can there be any other cause for hypokalemia in this case?
There are several case reports of Ogilvie’s syndrome being associated with severe hypokalemia
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Here’s an infographic describing the various mechanisms of hypokalemia

Highlighted in brown = Present in this case

Shout out to @dana_m_larsen , my Nephrologist colleague from UCSF for the amazing infographic
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What do you do when there is a fluctuating acid base disorder in hypokalemia?

Keep Calm …

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Here’s a review of the initial clinical course:

Note that there was a fluctuating acid base balance -> look at the case summary
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The story doesn’t end here!
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The patient was treated with 50 mg of Spironolactone and Oral Potassium of 70 mmol per day and maintained normokalemia and normal bowel movements.
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Now that we know that there is a chloride, Potassium and Calcium loss disorder….

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Hey Everyone!

Join as tonight for a interesting case discussion on electrolytes

Here's a poll for #NephSky for starters 😀

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