Korean J Nephrol.
1997 Sep;16(3):563-566.
A Case of Obstructive Uropathy Accompanied with Severe Hypernatremia
- Affiliations
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- 1Department of Internal Medicine, Catholic University Medical College, Seoul, Korea.
Abstract
- The severe hypernatremia and hyperosmolar dehydration may occur in the patient with partial urinary tract obstruction. The altered tubular function may be the cause of hypernatremia, but it is not generally appreciated. We experienced a case of severe hypernatremia in a 64-year-old male who had suffered from benign prostate hypertrophy with both hydronephrosis. The mental status was lethargic and the serum sodium showed severe hypernatremia(193mEq/L). The urine specific gravity showed hypotonicity. This suggested that the nephrogenic diabetes insipidus was involved in the pathogenesis of hypernatremia. The hypernatremia may be aggravated by the avoidance of water intake, which is due to decreased thirst sensorium in the elderly. The foley catheter was inserted and postobstructive diuresis was occurred. Initially, the patient was managed with isotonic saline and then with half saline. The hypernatremia resolved after 10 days and the patient's status was fully recovered. To our knowledge, this is the first case of obstructive uropathy accompanied with severe hypernatremia in Korea.
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