Potassium Chloride Supplementation in Amino Acid-Containing Peritoneal Dialysate in Patients with Persistent Hypokalemia

NKF 2017 Spring Clinical Meetings Abstracts 1528 Steroid Combined Induced CT and Scleroderma Fluoroscopy Renal Guided Crisis Percutaneous Trans85 peritoneal Jaros, Nephrostomy Tube Insertion and Subsequent Antonin Christos Argyropoulos, Shaffi, POTASSIUM CHLORIDE SUPPLEMENTATION IN AMINO Kamran ACIDNephrolithotomy in a Patient withUniversity Left Ectopic Pelvic Kidney Rawan Al-Odat, Edgar Fischer. of New Mexico, CONTAINING PERITONEAL DIALYSATE IN PATIENTS WITH PERSISTENT Albuquerque, Ishtiaq Ahmed, NM, Ebadur USA Rahman, Zahrani. Prince HYPOKALEMIA: Joseph Coughlan, Jola Salavaci,Tarek Daniel Elliott, Pentec Sultan Military Medical City, Riyadh, Saudi Arabia Boothwyn, Pennsylvania, 154 Health, Acute Renal Failure fromUSA. Supplement Induced Bile Cast 10 CKD Hemorrhagic Shock with and Hemoperitoneum as a Fatal Manipatients undergoing peritoneal dialysis often experience chronic Sucessfully Treated Apheresis festationdisturbances, ofJohnson, Granulomatosis with Polyangiitis electrolyte including We the Mira Caroline Theresahypokalemia. Kinard, Jillevaluated Adamski, effect of adding KCl to aminoHospital, acid-containing peritoneal Emad AlMayo Jaber, Gaurav Jain, Souheil Saddekni. University Keddis. Clinic Phoenix, AZ,dialysate, USA referred to as intraperitoneal nutrition solutions (IPN), on serum of Alabama Hospital, Birmingham, AL, USA 156 Non-HCV Cryoglobulinemic MPGN with Cold Agglutinin PD patients with hypokalemia refractory to oral 13 potassium A RareinCase of ANCA Associated – Association or Vasculitis Cause? in a Patient Hemolytic Anemia supplementation. with Systemic Sclerosis Ghassan Kabbach, Rahim Dhanani, Israel George An EMR search resulted in 8 patients (M:F , 0.38; 58y)Kasago, who, between Sadeem Ali, Austin Rice, KCl Romualdo Talento, two Nauman Soryal, and Vivek Bose,received Rafia Chaudhry, 10/1/2010 10/1/2015, in IPN dailyMauricio for at least Monrroy, Shahid. Carolina University anddrawn. Vidant Medical Foulke L,East K. Albany Medical College, Albany, weeks and had aHongalgi subsequent serum potassium lab Lab values Center, Greenville, NC, USA from the start of therapy. 5 NY, had beenUSA obtained 26 days, on average, 14 patients Atypical Hemolytic Uremic Syndrome Can Present as CCPDon andAnion 3 utilized CAPD. 159 Zero utilized Tolerance Gap Malignant Hypertension and Renal Dysfunction KCl was added to IPN in concentrations ranging from 4 - 16 mEq/L Sathish Karmegam, Roberto Collazo-Maldonado. Methodist (10Shehzad - 40 mEq/day) on severity of hypokalemia and response to El Ali,based Farhang Ebrahimi, Mohammad Azmir, Health System, Dallas, TX, USA + was 3.0 mEq/L (range: 2.6 - Island, therapy. baseline serum [K ]Medical Saadi.Average Richmond University Center, Staten 160 Aldosteronism in Polycystic Kidney Disease: Hypertension 3.3mEq/L). On the subsequent lab draw, serum [K+] increased by an NY, USA Hiding in Plain Sight average of 1.0mEq/L (range: - 2.5mEq/L). 7 of 8 patients had 20 An Unusual Cause of 0.5 Cast Nephropathy Chandrashekar Kashyap, James Lynch Bailey, Frederic serum potassium reach of 1 3.5mEq/L or above 1 during the first2 month Anwar , Nada Bader . 1University Rawan Al-Odat , Faisal University, Rahbari-Oskoui. Atlanta, USA therapy. Hyperkalemia Emory was noted in one patient, but wasGA, 2resolved of dose Newadjustment. Mexico, No Albuquerque, NM, USA; University of otherPseudohyperkalemia adverse events were reported. 161 after Recognition of Reverse Missouri, Kansas City, MO, USA Hypokalemia patients can beJoshua difficult toL. treatRein, orally and can Siddhartha in PD Kattamanchi, Joseph A. 21 play Granulomatous Nephrotic Syndrome Secondary to a significantIcahn role inSchool patient morbidity and mortality. There is New Vassalotti. of Medicine at Mount Sinai, Sarcoidosis limited literature available regarding KCl supplementation within PD York, NY, USA solutions. Our research suggests that peritoneal dialysateNashat may present Omer Alrawi, Walid Ibrahim, Nehal Altaie, Imran, 164 High Anion Gap Metabolic Acidosis Due to 5- Oxoproline a safe and effective for potassiumState administration and a Detroit Yahya Osmanmedium Malik.Wayne University, with Low Dose Acetaminophen means to correct serum potassium in hypokalemic patients Medical Center, Detroit, MI, USA Sobia N toKhan, Arun Kottarathara,study Opeyemi Oladele, oralof supplementation. is warranted 23 unresponsive A Rare Case Spontenous Further Tumor Lysis Synrometo in a Sandeepappropriate Mallipattu, Nand K Wadhwa. Stony Brook determine KCl dosing in intraperitoneal solutions. Patient with Poor-Risk Germ Cell Cancer Medicine, Stony Brook, NY, USA Mohammed Alzubaidi1, Bhavna Bhasin2. 1Medical Univer165 Thrombotic Thrombocytpopenic Purpura in a Patient with sity of South Carolina, Charleston, SC, USA; 2Medical Goodpasture’s Disease: An Uncommon Association 86 College of Wisconsin, Milwaukee, WI, USA Aakanksha Khanna, NicholasNEPHROPATHY Tan, Matthew AND R D’Costa, CRYSTALGLOBULIN-INDUCED 24 KERATOPATHY. Type B Lactic Acidosis Due toSandhya Dialysis-Induced Thiamine MatthewMayo D’Costa, Manohar, MN, Joe Grande Sandra M Herrmann. Clinic, Rochester, USA Deficiency in aC.Patient with Seminoma Samih Nasr, Marie Hogan, Mayo Clinic, Rochester, MN, USA 167 Crystalglobulinemia, An Unusual Casea of Proteinuria with Rapidly Progressive rare complication monoclonal gammopathy Brigani Amante, Isaac Teitelbaum.of University of Colorado Renal Failure results from vascular deposition of crystallized monoclonal proteins Hospital, Aurora, CO, USA leading to tissueKhurana, injury. A patient presented with arthralgias, Ravkiran Tushar Thakur, Andrewblurred Herman, 25 vision, Autosomal Kidney resistant Dominant hypertensionPolycystic and renal failure. Slit Disease lamp examPresenting showed Rupesh Raina, Natthavat Tanphaichitr. Cleveland Clinic crystalline keratopathy. Kidney as a Spontaneous Acute biopsy Bloodrevealed Loss crystalglobulin Anemia and induced HemorAkron General Akron, OH, USA nephropathy. rhagic Shock 56yo man presented with aAssociated hypertensive with emergency, renalInhibition: failure 171 A Prolonged Ketoacidosis SGLT-2 Ahmad Anjak, K.polyarthritis Gaitonde,(spine, A. Malhotra, C.V.small Thakar. and migratory shoulders, knees, A history Case of Report joints). He was VA diagnosed with Center, seronegative arthritis and treated with Cincinnati Medical Cincinnati, OH, USA Jatinder Kohli, Stanleyadalimumab Goldfarb.and Hospital ofwithout University of sulfasalazine, infliximab 29 methotrexate, Hypoaldosteronism Presenting withvision Renal Salt Wasting improvement & reported intermittentPA, blurred which responded to Pennsylvania, Philadelphia, USA Disease and prior Absence of Hyperkalemic Hypercholremic A month he was hospitalized hypertensive 173 steroids. An “Atypical” Case of Exit Sitewith Infection in Peritoneal Acidosis emergency & acute renal failure (creatinine 5.4 mg/dl). Urinalysis Dialysis revealed 2+ blood and 2+ protein. Serologic workup (ANCA, Huda Arif, David Leehey. Loyola Universityhepatitis, Medical cryoglobulins & ADAMTS13) was negative. Two kidney biopsies AbhilashChicago, Koratala, Chornyy, Amir Kazory. Centre, IL, Volodymyr USAmicroangiopathy” were interpreted as “thrombotic (1A). With University of Florida, Gainesville, FL, USA & hypertension creatinine to 3.6 32 plasmapheresis Hypokalemic Metaboliccontrol, Alkalosis andimproved Hypertension in 175 mg/dL. Severe Kidney Injuryopinion, from TURP-Associated On Acute presentation for second workup revealed IgG Heme Blacks lambda M spike 5-10% Pigment Nephropathy 1 in serum & urine. 1 Bone marrow showed 1 , Huzaif Qaisar , Vikas , Mayur K. Patel1, Arif Asif lambda light chain plasma cells. Fat aspirateSingh was negative for amyloid. 1 1 Anubhav Behdad Besharatian, Sidney Slit lamp Sharma examKumar, revealed crystalline keratopathy (1B). Further , Suhsil Mehandru , Awais Masud1Kobrin, , Loay Indu 2of biopsy 1 Matthew Jonathan Hogan. University of Pennsylevaluation tissue revealed intravascular &glomerular Salman . Palmer, Jersey Shore University Medical Center, Seton crystalline vania, Philadelphia, PA, USA Hall-Hackensack-Meridian Schoolextracellular of Medicine, Neptune, structures that stained 2 178 NJ, A Rare of Macrophage Activating Syndrome Albany Medical College, Albany, NY, with USAwith USA;Case positive for lambda Renal Failure kappa on Follow pronase of 33 Ischemic Monomelic Neuropathy: negative A Long-Term immunofluorescence with Franklin Katherine Chaudhry, Krishna 2 PatientsLam, Without Fistula Wang, LigationRafia secondaryCollege, intravascular 1 Swati Mehta. Albany 1 1 Hongalgi, Medical Albany, , Vikas Singh , Huzaif Quaisar , Nina Jube2, Arif Asif thrombosis, consistent with crystalglobulin-induced nephropathy. He 1 1 1 NY, USA was initiated cyclophosphamide/bortezomib/dexamethasone. Mayur K.onPatel , Indu Sharma , Suhsil Mehandru , Awais 2 1 180 Crystalglobulinemia A Rare1, Case Fibrillary Glomerulonephritis Presenting Loay of Salman . Jersey Shore University Medical Masud can mimic rheumatological diseases and with Hemoptysis histologically can mimic thrombotic microangiopathy.School Kidney biopsy Center, Seton Hall-Hackensack-Meridian of Medi2 (including paraffin immunofluorescence) and slit lampCollege, exam canAlbany, cine, Neptune, NJ, USA; Albany Medical Swathi Lavudi, Chris Webster, Saleha Rizwan, James Reilly, establish the correct diagnosis and permit appropriate therapy. NY, Tina USA Ko. Allegheny Health Network, Pittsburgh, PA, USA

A2 A4 A38

37 Amyloidosis Treatment of Presenting Intracardiacwith Mycetoma a Post Renal 181 Nephroticin Syndrome and Transplant Patient of Systemic Nocardiosis with the ComVentricular Hypertrophy VITAMIN C INDUCED OXALATE NEPHROPATHY: Matthew bination Imipenem and Trimethoprim-Sulfamethoxazol Terry Le,ofHerrera Vittal Chundru, Louisiana D’Costa, Loren Hernandez, Phani Sandra Morisetti. Herrmann, Mayo Clinic,State University Health Sciences Center, Shreveport, LA, USA AshrafMN, Attia, Muddassar Mahboob; Prince Rochester, USAEbadur Rahman, Secondary hyperoxaluria can occur withRiyadh, excessive ingestion or Sultan MilitaryinMedical City, Saudi Arabia 182 Preeclampsia Association with Mirror Syndrome and absorption of oxalate or with substances that metabolize to oxalate, Nonimmune Hydrops Fetalis 40 Desalination and Polyuria Associated with Hypertonic such as vitamin C. We present a case of a patient with acute renal Saline andLeddy, Vasopressin in Govindasamy, 3 Hypervolemic Children Julia L. Rajesh Jamie A. Green. failure secondary to oxalate nephropathy after excessive consumption of vitamin Geisinger Danville, PA, College USA John C. ScottMedical Baird. Center, Columbia University of PhysiA 69 year old male with a history of diabetes mellitus, hypertension, cians & Surgeons, New York, NY, USA 190 Pancreatic Adenocarcinoma Mimicking Granulomatous with hyperlipidemia, iron deficiency anemia, and obstructive sleep apnea 43 Abaseline Unique Case ofofRenal Failure in a Patient with Hepatitis withPolyangitis creatinine 1.1mg/dL presented to the emergency room C withSadichhya a one week history ofChristopher progressive weakness, fatigue, dyspnea on Lohani, Iuliana Niculescu, Zarouk. Krishna Baradhi, Girgis.Sami University ofWilliam Oklaexertion and intermittent stools. He recently was treated for Beaumont Hospital, Royal Oak, MI, USA homa, Tulsa, OK,loose USA parotitis with ciprofloxacin. He was taking two tablets of ibuprofen per 193 Irrelevant ANCA Negative Pauci Immune 44 ‘Calcinosis Cutis’: A Marker of that Systemic Calcification inina day as well as vitamin C supplementation equatedCrescentic to 7 g/day GN aDialysis Man with Rheumatoid Arthritis during the week prior to presentation. ECG showed wide complex QRS Patient and peaked T waves. Mark Laboratory revealed creatinine of 11.8mg/dL, Dipesh Bunker, Mary Chester Wasko,ofBarbara KrishnaMaan, Baradhi, Christopher Girgis. University OklaBUN of 169mg/dL, potassium of 9mmol/L, bicarbonate of 10mmol/L Clark. Allegheny General Hospital, Pittsburgh, PA, USA homa, Tulsa, OK, USA and pH of 7.1. He underwent emergent dialysis. Catheter urinalysis 199 Refractory Hyponatremia in ina a Patient with Fungating revealed 51-100 RBCs, 4-10Infarction WBCs, occasional granular castsFemale and 45 Spontaneous Renal Middle Aged on calcium crystals. ANA, HIV, hepatitis serologies, ESR, CRP, Metastatic Melanoma Oraloxalate Contraceptives (OCs) LDH, haptoglobin, C. Diff and workup for infectious etiologies were Rui Mao, Thao P level Tran,wasKrishna Baradhi. of Khalid Bashir, Chamberlain Nnamdi Nwaohiri. all negative. Serum oxalate 112Obialo, mcmol/L prior toUniversity dialysis. Oklahoma, Schooland Community Medicine, Tulsa, OK, Morehouse School ofofdialysis Medicine, Atlanta, USA Given persistent oliguria dependence, heGA, underwent kidney USA biopsy which revealed numerous crystals in 46 Colorful Surprises: Drugintratubular Related calcium Urine oxalate Pigmentation associated with‘Lytes: acute tubular injury and mildfor interstitial inflammatory 201 Low on A aRare Etiology Proteinuria Outpatient Clinic, Case Series infiltrates focally rich in eosinophils consistent with oxalate Kirea Mazzolini, ElieAl Saber, Samaya Qureshi, Sheryl Jaime Baynes-Fields, Jonathan Lee,interstitial Poorvanshi Alag, nephropathy. Given the possibility of concomitant nephritis, Caberto, Rajeev Raghavan. Baylor College of and Medicine, he was placed on high dose prednisone without improvement he Irfan Ahmed, Sandeep Aggarwal. Drexel University College remains dialysisTX, dependent. Houston, USA of Medicine, Philadelphia, PA, USA Vitamin C induced oxalate nephropathy with varying doses has been 204 Paradoxical Interstitial Nephritis in described a Patient withDisease Crohn 48 Atypical HUS in a Patient with Inflammatory Bowel described in many case reports. In this case, we pathology Disease consistent with oxalateKevin nephropathy alongYezina with findings concerning for Kelly Beers, Zarrabi, Nigatu, Lea Baer, interstitial nephritis. Oxalate nephropathy can have similarCenter, findings in Chaitanya Mishra, Maria J. Thomas, Dominick Santoriello, Wilfred Lieberthal. Stony Brook Medical Stony the interstitium. We present this case raise awareness of careful Ron Lawrence S. toWeisberg. Cooper University Brook,Zanger, NY, USA supplement history when evaluating patients with renal failure. Hospital, Camden, NJ, USA 49 P-ANCA Positive Immune Complex Glomerulonephritis 209 Role of Dialysis in Acute Toxic Associated with Levamisole UseEncephalopathy Secondary to Hyperammonemia 88 Kelly Beers, Arun Kottarathara, Wilfred Lieberthal, Rajeev Gayatri Rebecca Sevag Demirjian. The Rohatgi. Nair, Northport VA Blonsky, Medical FROM Center, Northport, NY, PROSTHETIC VALVE ENDOCARDITIS Cleveland Clinic Foundation, Cleveland, OH, USA USA MYCOBACTERIUM CHIMAERA INFECTION CAUSING 212 Massive Pneumoperitoneum Patient On CCPD, 52 Granulomatous Prostatitis asina aRare Presentation ofTreated GranGRANULOMATOUS INTERSTITIAL NEPHRITIS: Jonathan Da with CT Guided Needle Aspiration Costa, Ahmed Abdalrhim, Ivan Porter, Peter Fitzpatrick, Cherise ulomatosis with Polyangiitis 1 1 1 Cortese, Nabeel Aslam; Mayo Clinic, Jacksonville, FL, USA. Charles Neustein, Patricia Kachur, Izuchukwu Nwakoby. , Rafia Chaudhry , Richard Blinkhorn , Loay Anum Bilal Mycobacterium chimaera (M. chimaera) 1 1,2 is 1 a rare infection associated Ocala Health, Ocala, FL, USA Salman , Elvira Gosmanova . Albany Medical College, with prosthetic valve replacement. Here we describe a case of 2 213 Relapse of IgA Nephropathy Following an Episode of Albany, NY, USA; Albany Stratton VA Medical Center, granulomatous interstitial nephritis caused by M. chimaera in a patient Rhabdomyolysis Albany, NY, USA with prosthetic aortic valve endocarditis. Nguyen, Izuchukwu Nwakoby. University of 53 63Thu-Cuc Skin A Rare Presentation of Post-Transplant years Rash: old female with aortic valve replacement 6 years prior,LymCentral Florida/Ocala Health, FL, weight USA loss 20 lbs phoproloferative Disorder hospitalized at outside hospital (OSH) Ocala, for fatigue, overFibrillary 3 months, anemia (Hgb 9.3Foulke, g/dL) elevated creatinineinSungeun ofa 2.8 214 Glomerulopathy and and Renal Cell Homan, Cancer Situs Anum Bilal, Llewellyn Suzanne mg/dL (no David prior creatinine value available). Fat padChaudhry. aspirate at OSH Inversus Totalis Patient Kim, Conti, Loay Salman, Rafia Albany suspicious for Center, amyloidosis whichNY, prompted hematology referral at our Medical Albany, Dmitri Nikolaenko, Mony USA Fraer. University of Iowa institution. On exam, BP 133/72, P 85/min, afebrile, no rashes and no Hospital andThe Clinics, Iowa USA 54 It Runs in Family: A City, Case IA, of Hyperkalemic Periodic edema. S.Cr 4 mg/dL, WBC 2.4K, Hgb 8.5g/dL. Urine analysis showed Paralysis An Unfriendly 215 Staphylococcus Pseudintermedius 1+ protein, small blood, 2wbc/hpf, <1 RBC/hpf.–Bone Marrow biopsy Companion Rebecca Blonsky, Georges Nakhoul. TheTEE Cleveland revealed a single granuloma, negative for amyloid. showingClinic aortic Foundation, Cleveland OH, USAstarted onDilek root Dmitri abscess Nikolaenko, & valve vegetation. Patient antibiotics, Shaun Fernandes, Ince, however, M. Lee blood cultures University were negative 7 days and–antibiotics discontinued. Sanders. ofatIowa, Iowa City, IA,Peritonitis: USA Related First 55 Peritoneal Dialysis and Pet BITE Subsequently fever (102F). Renal biopsy showed Reportedpatient Case developed ofDisease Rhizobium 218 Minimal Change in a Radiobacter Patient with Infection Systemic from Lupusa granulomatous nephritis, negative AFB stain. Prednisone 40 Cat Bite interstitial Erythematosus: A Case Report mg was started and Cr improved to 2.4 after 10 days. Blood cultures Benjamin Bluen, Kiljanek, Hans Obadan, RulaM. Abdulrahman, Jose Pace, Rajbir doneOdianosen before biopsy grewLukasz AFB+ Chimaera afterSchlecht, 15 days of Michelle Fuentes, Kyleantibiotic Krevolin, Larry Krevolin. University Chopra. Saint John’s therapy Episcopal Hospital, Far Rockaway, incubation. 3-drug was initiated &Drexel prednisone was College of cultures Medicine, Philadelphia, USAcreatinine NY, USA stopped. Repeat 1 month later were PA, negative, stabilize at 2.3mg/dL; follow upAfter TTE showed resolution of vegetation. 56 Anti-Thymocyte Globulin Induced Acute Injury in a 220 Blood Pressure Control Removal of Kidney Reninin Secreting This case highlights that M.Anemia Chimaera prosthetic valve endocarditis Patient withKidney Aplastic Atrophied can induce granulomatous interstitial nephritis. In patients with Chandrashekar Verma, Bassil. Eshetu Obole, Bohra, Robin Sean Shah, JasonClaude Prosek. OhioUniverState prosthetic valve replacement presenting with non-specific symptoms, sity of South Florida, Tampa,Center, FL, USA University Wexner Medical Columbus, OH, USA anemia, and renal dysfunction should prompt investigation for 57 Immune Complex Glomerulonephritis with Persistently – A Case 221 A SevereM.but Nonfatal Case of Hypermagnesemia disseminated Chimaera infection. Negative ANA Assay Report

87

Am J Kidney Dis. 2017;69(4):A1-A105