A case report of severe hypernatremia followed by rhabdomyolysis and acute renal failure.

DOI
  • Narita Ichiei
    Department of Medicine (II), Niigata University School of Medicine
  • Sega Hiroyuki
    Department of Medicine (II), Niigata University School of Medicine
  • Gejyo Fumitake
    Department of Medicine (II), Niigata University School of Medicine
  • Arakawa Masaaki
    Department of Medicine (II), Niigata University School of Medicine

Bibliographic Information

Other Title
  • 高ナトリウム血症に続発したｒｈａｂｄｏｍｙｏｌｙｓｉｓにより急性腎不全を呈した１例

Abstract

We report a case of hypernatremia associated with rhabdomyolysis and acute renal failure. A 58-year-old man, who had suffered from cerebral hemorrhages at the ages of 46 and 48, was admitted to a hospital because of loss of appetite. Severe hypernatremia was noticed at that time. He developed pneumonia, followed by gastrointestinal bleeding and anuria, and was transferred to our hospital on September 17, 1988. Laboratory data at admission showed serum sodium 191mEq/l, potassium 4.8mEq/l, chloride 142mEq/l, urea nitrogen 270mg/dl, creatinine 6.7mg/dl, uric acid 11.0mg/dl, and CPK 20, 490IU/l with an MM fraction of 97%. Plasma osmolality was 461mOsm/kgH2O, and urine osmolality 462mOsm/kgH2O. The serum level of myoglobin was over 3×104ng/ml and it was also positive in urine. Rhabdomyolysis associated with acute renal failure seemed to be caused by severe hypernatremia due to hyperosmotic dehydration in this case. Short-term hemodialysis using a high-sodium dialysate (153mEq/l) and infusion of hypotonic sodium chrolide solution were started immediately. On the 4th hospital day, serum sodium was normalized to 140mEq/l. Renal function recovered remarkably after 12 hemodialysis treatments.

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Details 詳細情報について

  • CRID
    1390001204675164800
  • NII Article ID
    130003720909
  • DOI
    10.4009/jsdt1985.23.1317
  • ISSN
    18846211
    09115889
  • Text Lang
    ja
  • Data Source
    • JaLC
    • Crossref
    • CiNii Articles
  • Abstract License Flag
    Disallowed

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