A boy with bilateral complete duplication of the renal pelvis and ureter who required management of acidosis after augmentation enterocystoplasty

Abstract

We report a 12-year-old boy with stage 3 chronic kidney disease who developed metabolic acidosis and growth retardation after augmentation enterocystoplasty for neurogenic bladder. In infancy, he was diagnosed with recurrent urinary tract infections, bilateral complete duplication of the renal pelvis and ureterobladder transitional stenosis, and underwent bilateral ureterobladder neoanastomosis. He subsequently had repeated urinary tract infections. He was undergoing clean intermittent catheterization for vesicoureteral reflux and neurogenic bladder. However, due to difficulties in managing his urinary incontinence, he underwent bowel use bladder enlargement at the age of 12 years. As a postoperative complication, he repeated anion gap normal hyperchloremic metabolic acidosis, thought to be caused by the contact of urine with the intestinal wall, requiring alkalizing agents for more than 5 years. The growth curve, which had temporarily stagnated postoperatively, showed a trend towards improvement after the start of acidosis management. It is important to recognize that metabolic acidosis can occur after augmentation enterocystoplasty and that acidosis can affect growth.