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Acute tubular dysfunction in infants with obstructive uropathy.

A J vd Heijden, F G Versteegh, E D Wolff

    Acta Paediatrica Scandinavica
    |July 1, 1985
    PubMed
    Summary
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    Severe hyponatraemia, hyperkalaemia, and metabolic acidosis in patients with urinary tract infections and obstructive uropathy mimic adrenocortical disorders. Antibiotic and sometimes surgical therapy can correct these metabolic disturbances.

    Area of Science:

    • Nephrology
    • Endocrinology
    • Urology

    Background:

    • Urinary tract infections (UTIs) and obstructive uropathy can lead to severe electrolyte imbalances.
    • These imbalances, including hyponatraemia, hyperkalaemia, and metabolic acidosis, can mimic endocrine disorders.

    Observation:

    • Eleven patients presented with severe hyponatraemia, hyperkalaemia, and metabolic acidosis.
    • The clinical presentation was associated with concurrent urinary tract infection and obstructive uropathy.
    • This constellation of symptoms mimicked primary adrenocortical insufficiency.

    Findings:

    • Urine culture and abdominal ultrasound are crucial for diagnosing urinary tract obstruction.
    • The underlying metabolic disturbances were successfully corrected in most patients.

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  • Treatment primarily involved antibiotic therapy, with surgical intervention in some cases.

    • Implications:

    • Recognizing this clinical entity is vital for accurate diagnosis and timely management.
    • Prompt treatment of UTIs and uropathy can resolve severe metabolic derangements.
    • Persistent polyuria may occur even after successful metabolic correction.