A Case of Acute Renal Failure Caused by Hyperosmolar Hyperglycemic State Induced-Rhabdomyolysis.
- Author:
Der Sheng SUN
1
;
Seung Hwan SHIN
;
So Young LEE
;
Tae Seo SON
;
Young Soo KIM
;
Sun Ae YOON
;
Hyun Sik SON
;
Young Ok KIM
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. cmckyo@catholic.ac.kr
- Publication Type:Case Report
- Keywords:
Acute renal failure;
Rhabdomyolysis;
Hyperosmolar hyperglycemic state;
Diabetes mellitus
- MeSH:
Acute Kidney Injury*;
Coma;
Creatine;
Creatinine;
Dehydration;
Diabetes Mellitus;
Diuresis;
Glucose;
Humans;
Insulin;
L-Lactate Dehydrogenase;
Male;
Middle Aged;
Mouth Mucosa;
Necrosis;
Osmolar Concentration;
Physical Examination;
Renal Dialysis;
Rhabdomyolysis
- From:Korean Journal of Nephrology
2006;25(4):645-649
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Acute renal failure is the most common complication of rhabdomyolysis. However, hyperosmolar hyperglycemic state (HHS) induced-rhabdomyolysis rarely causes acute renal failure (ARF) because HHS induces osmotic diuresis and prevents tubular necrosis. Here we report a case of acute renal failure caused by HHS-induced rhabdomyolysis in a patient with poorly controlled diabetes mellitus. A 59-year-old male was admitted with comatose mentality. He had been diagnosed with diabetes mellitus 6 months ago but had not been treated. Physical examination showed severe dehydration of oral mucosa. His laboratory findings demonstrated severe HHS, rhabdomyolysis and acute renal failure (plasam glucose 1,543 mg/dL, osmolarity 329 mOsm/L, creatine phophokinase 15,395 IU/L, lactate dehydrogenase 1,046 IU/L, creatinine 2.4 mg/dL). With adequate hydration and insulin therapy, HHS improved but rhabdomyolysis and ARF were more aggravated. With early hemodialysis treatment, he finally improved without sequale.