Acute renal failure after a beer-drinking binge.

Abstract

526BRITISH MEDICAL JOURNAL 23 FEBRUARY 1980 0-060 (normal < 0-022), and malabsorption of radiocalcium. We concluded that the hypercalcaemia was resorptive although there was no radiological evidence of bone lesions. A saline diuresis was started using 7 1 of 0 9 ,' saline and 2 1 of 5 % dextrose over the next 24 hours. Despite maintenance of fluid balance and a urinary loss of 27-3 mmol (1092 mg) of calcium (normal < 9 mmol/day) plasma calcium and renal function remained unchanged (fig).Peritoneal dialysis was then started using 2-1 exchanges and a dwell time of four hours. The dialysis fluid, which was calcium-free, was composed of combinations of 09 % saline, 5 % dextrose, and small amounts of 50 % dextrose, diluted if necessary with sterile water to achieve an appropriate sodium concentration. The patient also received 4 1 of 4 % dextrose, 0 18°' saline intravenously daily with potassium supplementation. Within 17 hours the plasma calcium concentration had fallen to 4-23 mmol/l (16.92 mg/l00 ml) and the patient became responsive and rational. Plasma creatinine also fell. Dialysis was continued for three days maintaining a total calcium output of more than 20 mmol/day (800 mg/day) despite a falling plasma level. Half of this was urinary loss and the remainder peritoneal. Plasma calcium fell to 2-90 mmol/l (11-60 mg/100 ml) and the patient was well enough to tolerate endoscopy. This revealed a squamous carcinoma of the oesophagus. In view of the hepatic metastases active management was withdrawn and the patient died 14 days later.

Flank Pain and Acute Renal Failure after Binge Drinking:A Growing Concern?

“…Alcohol may induce direct muscle injury, rhabdomyolysis, myoglobinuria, and therefore acute tubular necrosis. [13][14][15] As shown in both the cases, with normal CK levels, the ethanol-induced ARF in this syndrome is caused by a mechanism different from rhabdomyolysis. However, there are reports showing a slight increase of CK after binge drinking that may reflect some degree of muscle damage but not enough to satisfactorily explain ARF.…”

The Beer Drinker’s Kidney

“…The data presented by Ghose et al [1] suggest the presence, in the beer consumed by the reported subjects, of a noxious agent other than the alcohol itself. Perhaps, here as in North America, cobalt has been incorporated into the beer during its manufacture.…”

Acute Renal Failure Caused by Alcohol-Induced Rhabdomyolysis

“…The first cases were reported in 1955, 1957 and 1962 [2-4]. Thereafter articles comprising 5 or 6 cases have been published [5][6][7][8].…”