Combined renal tubular acidosis and diabetes insipidus in hematological disease.
Background: A 39-year-old male with multiple myeloma was admitted for treatment with melphalan and autologous stem cell reinfusion. He presented with hypokalemia and hyperchloremic non-anion-gap metabolic acidosis with a high urinary pH. He also had hypomagnesemia, hypophosphatemia, hypouricemia, proteinuria and glucosuria. The patient subsequently developed polyuria with a low urine osmolality, hypernatremia and, finally, acute renal failure.
Methods: Physical examination, blood and urine analyses, kidney biopsy and tonicity balance. Methods: Fanconi syndrome with proximal (type II) renal tubular acidosis caused by myeloma kidney. Renal tubular acidosis was complicated by probable nephrogenic diabetes insipidus and acute renal failure.
Results: Potassium supplementation, sodium bicarbonate therapy, intravenous fluid therapy and dialysis.
Aspergillosis, Fanconi Bickel Syndrome, Magnesium Deficiency, Myelodysplastic Syndrome (MDS), Renal Tubular Acidosis, Primary Tubular Proximal Acidosis, Metabolic Acidosis, Hypophosphatemia, Distal Renal Tubular Acidosis, Proximal Renal Tubular Acidosis, Nephrogenic Diabetes Insipidus, Fanconi Syndrome, Multiple Myeloma