Metabolic Acidosis Reversed by the Combination of Magnesium Hydroxide and a Cation-Exchange Resin

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Abstract
WE recently observed the reversal of metabolic acidosis in a patient with chronic renal failure after the use of a cation-exchange resin, sodium polystyrene sulfonate (Kayexalate), and magnesium hydroxide (milk of magnesia) used as a cathartic to reinforce the action of the resin.Case ReportA 43-year-old man with chronic membranoproliferative glomerulonephritis and nephrotic syndrome was admitted to the Philadelphia Veterans Administration Hospital because of uncontrolled hypertension and chronic renal failure. Positive physical findings included a blood pressure of 230/160, marked retinal arteriolar narrowing, with waxy exudates, bilateral papilledema with a pericentral scotoma on the right, appreciable cardiomegaly with a . . .