{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:00Z","timestamp":1756425780104,"version":"3.44.0"},"reference-count":6,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,4,15]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p>A man in his 20s, a patient with chronic kidney disease with a baseline estimated glomerular filtration rate of 33\u2009mL\/min\/1.73 m<jats:sup>2<\/jats:sup>, who had an Indiana pouch continent urinary diversion procedure done at 6 years of age for bladder exstrophy, presented to the emergency room with sudden-onset progressive quadriparesis over 6\u2009hours with power 1\/5 in all the limbs with preserved reflexes. He was fully conscious and oriented, with stable vital signs. On evaluation, he had severe hypokalaemia and severe metabolic acidosis (both high anion gap and non-anion gap acidosis). Imaging studies showed bilateral gross hydroureteronephrosis, and renal and pouch calculi. Hypokalaemia was promptly treated with intravenous potassium chloride and acidosis with emergency haemodialysis. The patient had a complete motor recovery following intravenous potassium correction and was discharged with oral potassium and bicarbonate supplements. Here, the Indiana pouch, its metabolic and electrolyte complications, and its treatment are discussed.<\/jats:p>","DOI":"10.1136\/bcr-2021-248123","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T11:58:11Z","timestamp":1651233491000},"page":"e248123","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Hypokalaemic quadriparesis in a patient with urinary diversion through Indiana pouch"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5133-5420","authenticated-orcid":false,"given":"Srinivasa Anurag","family":"Kuchulakanti","sequence":"first","affiliation":[{"name":"General Medicine, KS Hegde Medical Academy, Mangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pradeep M","family":"Shenoy","sequence":"additional","affiliation":[{"name":"Nephrology, KS Hegde Medical Academy, Mangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,4,29]]},"reference":[{"key":"2025082801044552000_15.4.e248123.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-0143(05)70419-5"},{"key":"2025082801044552000_15.4.e248123.2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2011\/764325","article-title":"Metabolic changes after urinary diversion","volume":"2011","author":"Van der Aa","year":"2011","journal-title":"Adv Urol"},{"key":"2025082801044552000_15.4.e248123.3","doi-asserted-by":"publisher","DOI":"10.1159\/000030417"},{"key":"2025082801044552000_15.4.e248123.4","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1097\/MOU.0000000000000222","article-title":"Long-Term complications of urinary diversion","volume":"25","author":"Amini","year":"2015","journal-title":"Curr Opin Urol"},{"key":"2025082801044552000_15.4.e248123.5","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/s13730-015-0187-9","article-title":"Hypokalemia-associated paralysis and metabolic acidosis in a patient with bilateral ureterosigmoidostomy","volume":"5","author":"Niwa","year":"2016","journal-title":"CEN Case Rep"},{"key":"2025082801044552000_15.4.e248123.6","first-page":"e14638","article-title":"Urinary diversion and metabolic acidosis: a case report","volume":"13","author":"Dsouza","year":"2021","journal-title":"Cureus"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-248123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:04:52Z","timestamp":1756368292000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-248123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":6,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,29]]},"published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1136\/bcr-2021-248123"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-248123","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}