Severe hyperkalemia following ureteroileostomy: A case report and literature review

Abstract

Metabolic complications, including hyponatremia and metabolic acidosis have been reported following urinary diversion operations, occasionally together with hyper- or hypokalemia, depending on the bowel segment used. While Hypokalemia often accompanies ureterosigmoidostomy and may develop following ileal conduits, we report a rare case of recurrent life threatening hyperkalemia following this procedure, associated with hyponatremia and acidosis. Reviewing the English literature (1973 to 2016) we found 25 cases of hyperkalemia complicating ureteral diversion procedures, mostly after jejunal conduits. Only five cases of hyperkalemia were described after ileal conduit surgeries, including the current report. We discuss the nature of the metabolic and electrolyte disturbances following urinary diversion and debate possible reasons for the rare cases of hyperkalemia complicating ileal conduits.