The Korean Journal of Medicine

  • 제83권5호
  • /
  • Pages.664-667
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  • 2012
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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Acetazolamide에 의해 발생한 핍뇨성 급성신부전 1예

A Case of Oliguric Acute Renal Failure Caused by Acetazolamide

  • 최용혁 (충북대학교 의과대학 내과학교실) ;
  • 이희승 (충북대학교 의과대학 내과학교실) ;
  • 김선문 (충북대학교 의과대학 내과학교실) ;
  • 김혜영 (충북대학교 의과대학 내과학교실) ;
  • 나소영 (청주성모병원 내과) ;
  • 권순길 (충북대학교 의과대학 내과학교실)
  • Choi, Yong Hyeok (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • Lee, Hee Seung (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • Kim, Sun Moon (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • Kim, Hye-Young (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • Rha, So Young (Department of Internal Medicine, Saint Mary's Hospital) ;
  • Kwon, Soon Kil (Department of Internal Medicine, Chungbuk National University College of Medicine)
  • 발행 : 2012.11.01
⟨ 이전 논문 다음 논문 ⟩

초록

Acetazolamide는 탄산탈수효소 억제제로 고령이나 신기능이 저하된 환자에서 대사성 산증이나 급성신부전을 일으킬 수 있다. 저자들은 녹내장 치료를 위해 acetazolamide를 복용하던 정상 신기능의 당뇨병 환자에서 대사성산증을 동반한 핍뇨성 급성신부전을 혈액투석으로 치료한 증례를 경험하였다. 따라서 정상 신기능을 가진 녹내장 환자에서도 acetazolamide를 사용하는 경우 신부전의 위험성을 고려하여 주의 깊은 관찰이 필요할 것으로 생각된다.

Acetazolamide is a carbonic anhydrase inhibitor commonly used to treat glaucoma. It can cause metabolic acidosis and renal failure in the elderly and patients with chronic renal insufficiency. We report oliguric acute renal failure (ARF) caused by a conventional dose of acetazolamide for glaucoma in a patient with normal renal function. A 56-year-old woman with 20-year history of diabetes had general weakness, decreased urine output, nausea, and vomiting for 3 days. For the past 2 weeks, her glaucoma had been treated with acetazolamide. Blood-gas analysis showed pH 7.02, $PCO_2$ 27 mmHg, PO2 135 mmHg, and ${HCO_3}^-7.0mmol/L$. Her BUN was 65 mg/dL and creatinine, 9.1 mg/dL. She recovered after hemodialysis and hydration. Acetazolamide may cause severe ARF, even in patients with normal renal function, suggesting the importance of careful monitoring of renal function in patients taking acetazolamide.

키워드

참고문헌

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