Deterioration of Chronic Renal Dysfunction and Serum Electrolyte Disorders Associated with Massive Ileostomy Effluent

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A 27-year-old man with a 16-year history of Crohn's disease was referred to our hospital because of general fatigue and electrolyte disorders. The past medical history included chronic renal dysfunction due to renal amyloidosis and permanent ileostomy performed 2 years earlier. Laboratory findings on admission showed hypochloremia, hypokalemia, metabolic alkalosis, and acute deterioration of chronic renal dysfunction. The above disorders were considered to be due to dehydration caused by excessive loss of fluid and electrolyte from the ileostomy. Dehydration and electrolyte disorders were corrected by proper rehydration, which also improved renal dysfunction to the basal level. Although renal failure due to massive ileostomy effluent is rare, clinicians should be aware of possible dehydration in ileostomists, and treat such patients with water and electrolyte.