Recurrent metabolic alkalosis and elevated troponins after crack cocaine use in a hemodialysis patient.

When acid-base disorders have been described after cocaine use, they are usually metabolic acidosis. We report a case of recurrent crack cocaine use associated with severe metabolic alkalosis on two successive admissions, in a patient in renal failure on hemodialysis and with minimal urine output, despite no history of vomiting or alkali ingestion. The metabolic alkalosis did not recur after counseling and abstention from cocaine.