Severe hypokalemia in a hemodialysis patient: a case report

A 59-year-old male with diabetic nephropathy, who had undergone maintenance hemodialysis for one year, developed watery diarrhea and subsequent loss of appetite for one month. On June 5th, the patient complained of general weakness after hemodialysis. Severe hypokalemia (1.3 mEq/L) was found and was admitted to our hospital. We corrected hypokalemia by intravenous and oral administration of potassium. CT and barium enema demonstrated a tumor of the ascending colon. Colonoscopy showed a submucosal tumor at the colonic site near Bauhin's valve. After colectomy, watery diarrhea stopped. Histologically, the tumor was a lipoma. In anuric patients with chronic kidney disease, hypokalemia is very rare. In the present case, unbalanced diet and continual diarrhea were the cause of severe hypokalemia.