Acceso usuarios
Lidia Ferrer Luna, Alberto Villota Bello, Helena Vicente Pastor, Estefanía Casas Sicilia, María Cuello Sanz, Marta Morera Harto
Varón de 71 años con antecedentes fundamentalmente de diabetes mellitus en tratamiento que es valorado por marcada postración, vómitos alimentarios esporádicos e incremento del ritmo deposicional con evacuación de deposiciones acuosas prácticamente de manera horaria. Desde hace dos meses, presenta cuadro de diarrea creciente acuosa en cuyo contexto se realizó inicialmente una colonoscopia que no advirtió alteraciones significativas. A la exploración física, sin hallazgos significativos. Analíticamente, se objetiva fracaso renal agudo anúrico con acidosis metabólica severa e hipotensión que no mejora con fluidoterapia, antibioterapia y reposición de bicarbonato. Por lo que se decide ingreso en unidad de cuidados intensivos para iniciar drogas vasoactivas y depuración extrarrenal con hemofiltro. Pasó a planta donde se terminó de recuperar y finalmente, fue dada de alta como diarrea inducida probablemente por metformina que se complicó con fracaso renal por el efecto contributivo desfavorable de su tratamiento habitual.
A 71-year-old male with a history mainly of diabetes mellitus in treatment that is assessed for marked prostration, sporadic food vomiting and increased depositional rhythm with evacuation of watery stools practically hourly. For two months, he has presented a picture of increasing watery diarrhea in which context a colonoscopy was initially performed that did not detect significant alterations. On physical examination, without significant findings. Analytically, acute anuric renal failure was observed with severe metabolic acidosis and hypotension that did not improve with fluid therapy, antibiotic therapy and bicarbonate replacement. Therefore, it was decided to be admitted to the intensive care unit to start vasoactive drugs and extrarenal clearance with hemofilter. He went to the ward where he finished recovering and finally, he was discharged as diarrhea probably induced by metformin that was complicated by renal failure due to the unfavorable contributory effect of her usual treatment.
