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| 심한 고나트륨혈증을 동반한 폐쇄성 요로병증 1예 |
| 문성배 , 김보경 , 김영수 , 이숙경 , 윤성노 , 이종민 , 진동찬 , 김석영 , 방병기 |
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| Abstract |
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The severe hypernatremia and hyperosmolar dehy- dration 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 hyper- natremia 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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