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Case Reports in Nephrology
Volume 2015 (2015), Article ID 309791, 3 pages
Case Report

Hyperchloremic Metabolic Acidosis due to Cholestyramine: A Case Report and Literature Review

1University of Calgary, Suite G15, 1403-29 Street NW, Calgary, AB, Canada T2N 2T9
2University of Toronto and University Health Network, Toronto General Hospital, Room 8N-842, 200 Elizabeth Street, Toronto, ON, Canada M5G 2C4

Received 13 July 2015; Accepted 30 August 2015

Academic Editor: Yoshihide Fujigaki

Copyright © 2015 Fareed B. Kamar and Rory F. McQuillan. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cholestyramine is a bile acid sequestrant that has been used in the treatment of hypercholesterolemia, pruritus due to elevated bile acid levels, and diarrhea due to bile acid malabsorption. This medication can rarely cause hyperchloremic nonanion gap metabolic acidosis, a complication featured in this report of an adult male with concomitant acute kidney injury. This case emphasizes the caution that must be taken in prescribing cholestyramine to patients who may also be volume depleted, in renal failure, or taking spironolactone.