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Acute tubular necrosis (ATN) presenting with an unusually prolonged period of marked polyuria heralded by an abrupt oliguric phase.
- Source :
-
BMJ case reports [BMJ Case Rep] 2014 Aug 22; Vol. 2014. Date of Electronic Publication: 2014 Aug 22. - Publication Year :
- 2014
-
Abstract
- A 50-year-old African-American man presented with acute tubular necrosis (ATN) secondary to hypotension from non-typhoid Salmonella gastroenteritis and bacteraemia. The oliguric phase lasted only 24 h followed by prolonged polyuria for 20 days, with urine output in excess of 16 L/day at maximum. As indexed in PubMed this is only the second published case of this nature since 1974, in which an abrupt oliguric phase of 24 h or less heralded prolonged polyuria in ATN. The diagnosis is challenging as fractional excretion of sodium early in the clinical course and rapid normalisation of serum creatinine with intravenous fluids (IVF) may point towards prerenal azotaemia resulting in a premature discharge from hospital. Patients with an abrupt oliguric phase may suffer a secondary renal insult from the profound fluid loss that is to follow and may need inpatient monitoring with supplemental IVF to prevent deleterious outcomes.<br /> (2014 BMJ Publishing Group Ltd.)
- Subjects :
- Creatine Kinase blood
Creatinine blood
Creatinine urine
Diagnosis, Differential
Follow-Up Studies
Humans
Hypotension complications
Kidney Tubular Necrosis, Acute diagnosis
Kidney Tubular Necrosis, Acute metabolism
Male
Middle Aged
Oliguria diagnosis
Oliguria metabolism
Polyuria diagnosis
Polyuria metabolism
Kidney Tubular Necrosis, Acute complications
Oliguria etiology
Polyuria complications
Subjects
Details
- Language :
- English
- ISSN :
- 1757-790X
- Volume :
- 2014
- Database :
- MEDLINE
- Journal :
- BMJ case reports
- Publication Type :
- Academic Journal
- Accession number :
- 25150229
- Full Text :
- https://doi.org/10.1136/bcr-2013-201030