The occasional development of alkalosis during treatment with alkalis in individuals suffering from duodenal ulcer has, since Hardt and Rivers'1 description in 1913, been mentioned frequently in the literature2 and may take place even when no alkali has been used, provided severe intestinal obstruction with loss of chloride ions and of acids occurs.3 It has even longer been recognized that in renal disease alkalis may not be well tolerated,4 and the appearance of alkalosis during a course of treatment involving their use has in fact been regarded as evidence that the kidneys were already injured. Hardt and Rivers1 suggested that prolonged use of alkalis might injure the kidneys, even in the absence of preexisting renal disease. Cases of damage due to this source have subsequently been described by Houghton3 and by Jordan.2 Berger and Binger4 have recently reported a case of renal
STEELE JM. RENAL INSUFFICIENCY DEVELOPING DURING PROLONGED USE OF ALKALIS: REPORT OF A CASE. JAMA. 1936;106(24):2049–2050. doi:10.1001/jama.1936.02770240013004
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