Acid-base metabolism after bladder substitution with the ileal urethral Kock reservoir

British Journal of Urology
A L Poulsen, K Steven


To assess acid-base metabolism after bladder substitution with the ileal Kock reservoir, using capillary blood-gas analysis, measurement of the renal excretion of ammonium and titratable acid and the evaluation of renal function by plasma clearance of 51Cr-labelled ethyl-enediamine tetra-acetic acid (51Cr-EDTA). The investigation comprised both a cross-sectional study, with initial measurements after surgery, and a longitudinal study, with pre-operative measurements, both groups of patients being followed for 2 years after inclusion. The cross-sectional study included 26 patients (median age 66 years, range 44-75), with a median post-operative follow-up of 1.2 years (range 0.3-3.7), and 16 control subjects (median age 62 years, range 34-80), and the longitudinal study comprised seven patients (median age 57 years, range 42-68). The median values for capillary blood pH, carbon dioxide pressure, standard bicarbonate and standard base excess were significantly lower in patients with a bladder substitute than in the control subjects. An acid-base chart showed that the values for 44% of patients and none of the controls were within the area representing mild metabolic acidosis. This difference could not be attributed to differences ...Continue Reading


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