A CASE OF HYPEROSMOLAR COMA WITH HYPERNATREMIA AND HYPERCHLOREMIA CAUSED BY OBSTRUCTION OF LOWER URETHRA IN A DIABETIC PATIENT / 中华内分泌代谢杂志

ABSTRACT

This article reports the development of hyperosmolar hypernatremic hyperchloremic coma and acute renal failure in a male diabetic patient after recovery from hyperosmolar hypergly-cemic nonketonic coma, of which the cause is fluid retention in excess of urinary output due to the obstruction of lower urethra by diabetic neurogenic urinary bladder and hyper-plasia of prostate gland.By our experience each old diabetic man should be examined to confirm if he has neuro-genic urinary bladder and/or hyperplasia of prostate gland. Care should be taken to keep the balance of fluid intake and output provided that both of these conditions are present. The acute obstructive nephropathy can quickly ameliorate with release of the obstruction.