We report quadriparesis as a result of severe hypokalaemia and acidosis in
a 50-year-old man who had undergone ureterosigmoidostomy for bladder
extrophy 48 years earlier. Aggressive suppletion with intravenous
potassium and bicarbonate combined with potassium-sparing diuretics and
ACE inhibitors resulted in complete restoration of the serum potassium and
resolution of the neurological symptoms. The underlying mechanism as well
as the treatment of hypokalaemia and hyperchloraemic metabolic acidosis
after ureterosigmoidostomy are briefly discussed