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Hypernatremia secondary to partial urinary tract obstruction: a case report.
Shizhe Zhou1, Tianyuan Li1, Chenxiang Cao1
1Department of Endocrinology and Metabolism, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Frontiers in Endocrinology
|April 8, 2026
Summary
Partial urinary tract obstruction can cause severe hypernatremia by affecting kidney function. Surgical relief of the obstruction rapidly normalized sodium levels in a patient with unexplained hypernatremia.
Area of Science:
- Nephrology
- Urology
- Endocrinology
Background:
- A 52-year-old male presented with polydipsia, polyuria, and urinary foam.
- Initial diagnosis was type 2 diabetes mellitus with hyperglycemic hyperosmolar state (HHS).
- Despite glycemic control, the patient developed severe, unexplained hypernatremia.
Purpose of the Study:
- To report a case of severe hypernatremia secondary to partial urinary tract obstruction.
- To highlight the importance of considering urinary tract obstruction in unexplained hypernatremia.
Main Methods:
- Standard medical management including insulin and fluid resuscitation.
- Urological intervention including transurethral holmium laser enucleation of the prostate and cystolithotripsy for benign prostatic hyperplasia, hydronephrosis, and bladder calculi.
Main Results:
- Post-urological surgery, serum sodium levels normalized from 162.3 mmol/L to 139.7 mmol/L.
- Complete resolution of hypernatremia was observed following surgical intervention.
Conclusions:
- Partial urinary tract obstruction can impair renal concentrating ability, leading to hypernatremia.
- Investigating urinary tract obstruction is crucial in patients with unexplained hypernatremia, especially elderly males with urological symptoms.
- Surgical relief of obstruction can effectively treat hypernatremia.
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