Indian Journal of Critical Care Case Report

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VOLUME 2 , ISSUE 3 ( May-June, 2023 ) > List of Articles

CASE REPORT

Gastroenteritis-triggered BRASH Syndrome in a Patient with Chronic Kidney Disease: A Case Report

Amit Goel, Upendra Singh, Eshaan Patel, Mohd Javed

Keywords : Acute gastroenteritis, Bradycardia, renal failure, AV nodal blocking drugs, shock, and hyperkalemia syndrome, Chronic kidney disease, Hyperkalemia

Citation Information : Goel A, Singh U, Patel E, Javed M. Gastroenteritis-triggered BRASH Syndrome in a Patient with Chronic Kidney Disease: A Case Report. 2023; 2 (3):72-74.

DOI: 10.5005/jp-journals-11006-0055

License: CC BY-NC 4.0

Published Online: 26-06-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Introduction: Patients with chronic kidney disease (CKD) are on regular renal support. However, coexisting comorbidities, ongoing treatment and drug interactions requires exploration of other associated conditions which could prove life-threatening. Case description: We present here the management of a CKD patient on atrioventricular (AV) node-blocking medications with acute gastroenteritis presenting in shock, refractory bradycardia, and severe hyperkalemia. Conclusion: Bradycardia, renal failure, AV nodal blocking drugs, shock, and hyperkalemia (BRASH) syndrome is broadly reported in a group of CKD patients receiving long-term AV node blockers. Hypovolemia, renal hypoperfusion, and deranged renal parameters are major risk factors. Largely high morbidity and mortality are associated with BRASH syndrome. However, prompt diagnosis and management can lead to an overall better patient outcome.


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