Abstract
We report a case of rhabdomyolysis secondary to hyperosmolar nonketotic diabetic coma (HNKC) which led to acute renal failure. A 46-year-old male with no history of diabetic mellitus was admitted to another hospital because of malaise, polydipsia, polyuria and loss of consciousness. The laboratory findings at the other hospital were as follows: glucose 1, 500mg/dl, serum Na 151mEq/l, BUN 55mg/dl, Cr 1.9mg/dl, urine ketone bodies (+), CPK 1, 539IU. A diagnosis of HNKC was made. The patient's consciousness level improved after transfusion and insulin injection, however, he was transferred to our hospital because of deterioration of his renal function. On admission, the patient's BUN was 69.4mg/dl, Cr 6.8mg/dl, CCr 7ml/min, CPK 53, 400IU, LDH 2, 203IU and serum myoglobin 11, 000ng/ml. We made a diagnosis of acute renal failure caused by rhabdomyolysis due to HNKC. Hemodialysis was performed at seven times starting on the day of admission, and his renal function thereafter returned to normal. His diabetes mellitus was well controlled with diet therapy alone.
Acute renal failure due to rhabdomyolysis associated with HNKC is rare, but it is one of the most important complications. We concluded that the patient had NIDDM and consequently developed HNKC associated with rhabdomyolysis and acute renal failure. Hemodialysis was useful in restoring renal function in this patient.
