Korean J Nephrol.  2006 Jul;25(4):645-649.

A Case of Acute Renal Failure Caused by Hyperosmolar Hyperglycemic State Induced-Rhabdomyolysis

Affiliations
  • 1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. cmckyo@catholic.ac.kr

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.

Keyword

Acute renal failure; Rhabdomyolysis; Hyperosmolar hyperglycemic state; Diabetes mellitus

MeSH Terms

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
Creatine
Creatinine
Glucose
Insulin
L-Lactate Dehydrogenase
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