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Hyperchloraemic metabolic acidosis
  1. F S Y Fan,
  2. K M Chow,
  3. C C Szeto,
  4. P K T Li
  1. Department of Medicine and Therapeutics, Prince of Wales Hospital, the Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
  1. Dr K M Chow, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR, China; chow_kai_ming{at}


Cholestyramine carries a risk of hyperchloraemic metabolic acidosis. Being cognisant of this drug-induced adverse event may reduce diagnostic delays. Emergency physicians should be alert about this condition, in particular among patients with pre-existing chronic kidney disease, or who are taking spironolactone.

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  • Competing interests: None declared.

  • Patient consent: Obtained.