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Severe Hyponatremia Precipitated by Acute Urinary Retention in a Patient with Psychogenic Polydipsia
A woman in her late sixties presented with severe hyponatremia and acute kidney injury (AKI) as consequence of psychogenic polydipsia and acute urinary retention due to urinary tract infection. Urinary catheterization promptly drained 5.5 L of urine with resulting polyuria, leading to an initial swi...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414331/ https://www.ncbi.nlm.nih.gov/pubmed/32802531 http://dx.doi.org/10.1155/2020/8792897 |
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author | Hilton, C. M. H. Boesby, L. Nelveg-Kristensen, K. E. |
author_facet | Hilton, C. M. H. Boesby, L. Nelveg-Kristensen, K. E. |
author_sort | Hilton, C. M. H. |
collection | PubMed |
description | A woman in her late sixties presented with severe hyponatremia and acute kidney injury (AKI) as consequence of psychogenic polydipsia and acute urinary retention due to urinary tract infection. Urinary catheterization promptly drained 5.5 L of urine with resulting polyuria, leading to an initial swift raise in plasma (P) sodium concentration, disregarding the course of fluid resuscitation. After the polyuric phase, normal range P-sodium levels were reestablished by oral water restriction. Treatment with psychoactive drugs, e.g., zuclopentixol, may have contributed to the severity of the condition. There are few published reports regarding water intoxication and urinary retention, but none reflecting severe hyponatremia precipitated by acute urinary retention in a patient with polydipsia. By this report, we illustrate the detrimental consequences on water and electrolyte homeostasis of urinary retention and polydipsia resulting in acute water intoxication. The purpose of presenting this case is firstly to draw attention to the potentially fatal combination of polydipsia and postrenal acute kidney injury, where the kidneys are unable to correct the enormous excess water, then to focus on the difficulty in correcting hypervolemic hyponatraemia in the context of polyuria after relief of urinary retention, and finally, to point out that patients in treatment with antipsychotics may have further worsening of electrolyte derangement. |
format | Online Article Text |
id | pubmed-7414331 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-74143312020-08-14 Severe Hyponatremia Precipitated by Acute Urinary Retention in a Patient with Psychogenic Polydipsia Hilton, C. M. H. Boesby, L. Nelveg-Kristensen, K. E. Case Rep Nephrol Case Report A woman in her late sixties presented with severe hyponatremia and acute kidney injury (AKI) as consequence of psychogenic polydipsia and acute urinary retention due to urinary tract infection. Urinary catheterization promptly drained 5.5 L of urine with resulting polyuria, leading to an initial swift raise in plasma (P) sodium concentration, disregarding the course of fluid resuscitation. After the polyuric phase, normal range P-sodium levels were reestablished by oral water restriction. Treatment with psychoactive drugs, e.g., zuclopentixol, may have contributed to the severity of the condition. There are few published reports regarding water intoxication and urinary retention, but none reflecting severe hyponatremia precipitated by acute urinary retention in a patient with polydipsia. By this report, we illustrate the detrimental consequences on water and electrolyte homeostasis of urinary retention and polydipsia resulting in acute water intoxication. The purpose of presenting this case is firstly to draw attention to the potentially fatal combination of polydipsia and postrenal acute kidney injury, where the kidneys are unable to correct the enormous excess water, then to focus on the difficulty in correcting hypervolemic hyponatraemia in the context of polyuria after relief of urinary retention, and finally, to point out that patients in treatment with antipsychotics may have further worsening of electrolyte derangement. Hindawi 2020-07-30 /pmc/articles/PMC7414331/ /pubmed/32802531 http://dx.doi.org/10.1155/2020/8792897 Text en Copyright © 2020 C. M. H. Hilton et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Hilton, C. M. H. Boesby, L. Nelveg-Kristensen, K. E. Severe Hyponatremia Precipitated by Acute Urinary Retention in a Patient with Psychogenic Polydipsia |
title | Severe Hyponatremia Precipitated by Acute Urinary Retention in a Patient with Psychogenic Polydipsia |
title_full | Severe Hyponatremia Precipitated by Acute Urinary Retention in a Patient with Psychogenic Polydipsia |
title_fullStr | Severe Hyponatremia Precipitated by Acute Urinary Retention in a Patient with Psychogenic Polydipsia |
title_full_unstemmed | Severe Hyponatremia Precipitated by Acute Urinary Retention in a Patient with Psychogenic Polydipsia |
title_short | Severe Hyponatremia Precipitated by Acute Urinary Retention in a Patient with Psychogenic Polydipsia |
title_sort | severe hyponatremia precipitated by acute urinary retention in a patient with psychogenic polydipsia |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414331/ https://www.ncbi.nlm.nih.gov/pubmed/32802531 http://dx.doi.org/10.1155/2020/8792897 |
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