Korean J Med.  2015 Jul;89(1):102-106. 10.3904/kjm.2015.89.1.102.

Pseudo-Renal Failure with Severe Hyponatremia due to Spontaneous Bladder Rupture

• Kim BC
• Yim TH
• Kim JS
• Kim HR
• Oh HG
• Lee HJ
• Kim YM

• KMID: 2269058
• DOI: http://doi.org/10.3904/kjm.2015.89.1.102

Abstract

Spontaneous bladder rupture is rare. Such an occurrence may appear similar to renal failure because the resulting urine leakage into the peritoneal cavity and absorption across the peritoneum increases serum creatinine although glomerular filtration rate is normal. A 46-year-old man presented with abdominal distension for 7 days after consuming a large volume of alcohol. Initial laboratory tests showed a blood urea nitrogen level of 174.3 mg/dL, serum creatinine of 11.49 mg/dL, and serum sodium of 105 mmol/L. Abdominal distension resolved after draining 5,200 mL of urine through a bladder catheter. Computed tomography cystography revealed intraperitoneal leakage of contrast dye from the left dome of the bladder, suggesting an intraperitoneal bladder rupture. Azotemia was completely normalized on the third day of hospitalization. This case shows that pseudo-renal failure should be considered when caring for a patient with unexplained azotemia and ascites.

Keyword

Acute renal failure; Hyponatremia; Rupture, Spontaneous; Urinary bladder

MeSH Terms

Absorption
Acute Kidney Injury
Ascites
Azotemia
Blood Urea Nitrogen
Catheters
Creatinine
Glomerular Filtration Rate
Hospitalization
Humans
Hyponatremia*
Middle Aged
Peritoneal Cavity
Peritoneum
Renal Insufficiency
Rupture*
Rupture, Spontaneous
Sodium
Urinary Bladder*
Creatinine
Sodium