Whole-body potassium and bone mineral density up to 30 years after urinarydiversion

Objectives To evaluate the long-term effects of different types of urinary diversion on skeletal bone density and whole-body potassium content in pati ents with an early correction of base excess (< -2.5), Patients and methods The early correction of base excess (< -2.5) is one of the principles of the treatment of patients undergoing urinary diversion a t our institution, In 27 patients with urinary diversion, bone mineral dens ity (assessed by dual-photon absorptiometry), whole-body potassium, electro lyte and creatinine levels were determined, and capillary blood gas analyse d. The mean time since surgery was 16.8 years in 16 patients with a rectal reservoir, 20.5 years in six patients with a colonic conduit, 7.8 years in four patients with an ileocaecal pouch and 5 years in one adolescent with a n ileal bladder augmentation. Results Bone mineral density was normal in 25 of the 27 patients; no exact measurement was possible in the remaining two. The whole-body potassium con tent was reduced in eight of the 27 patients (three with a conduit, two wit h a rectal reservoir, two with an ileocaecal pouch and one with ileal augme ntation). In four of these eight patients the base excess was < -2.5 (-2.7 to -5). Of the other four, two had no regular testing of their base balance and two were obese. The electrolytes were within the normal ranges, None o f the patients had hyperchloraemic metabolic acidosis. Conclusion With early correction of the base excess (< -2.5), there was no decrease in bone mineral density and no hyperchloraemic acidosis. There was no significant difference between the different types of urinary diversion . There seems to be a relationship between low base excess and decreased wh ole-body potassium.