Development of Severe Hyponatremia due to Salt-Losing Nephropathy after Esophagectomy for Esophageal Cancer

A 72-year-old woman was admitted to our hospital for esophagectomy for esophageal cancer. On the third postoperative day, she developed polyuria (3.8 L/day), massive natriuresis, hyponatremia (112 mEq/L), hyperkalemia (5.6 mEq/L), and decreased central venous pressure, which was refractory to isoton...

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Main Authors: Katsunobu Yoshioka, Minako Nishio, Soichi Sano, Katsunobu Sakurai, Keiko Yamagami, Yoshito Yamashita
Format: Article
Language:English
Published: Wiley 2009-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2009/241283
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author Katsunobu Yoshioka
Minako Nishio
Soichi Sano
Katsunobu Sakurai
Keiko Yamagami
Yoshito Yamashita
author_facet Katsunobu Yoshioka
Minako Nishio
Soichi Sano
Katsunobu Sakurai
Keiko Yamagami
Yoshito Yamashita
author_sort Katsunobu Yoshioka
collection DOAJ
description A 72-year-old woman was admitted to our hospital for esophagectomy for esophageal cancer. On the third postoperative day, she developed polyuria (3.8 L/day), massive natriuresis, hyponatremia (112 mEq/L), hyperkalemia (5.6 mEq/L), and decreased central venous pressure, which was refractory to isotonic saline infusion. Laboratory findings indicated proximal tubular injury (high urinary β2-microglobulin, coexistence of hypouricemia) together with reduced aldosterone action at the cortical collecting duct. A diagnosis of salt-losing nephropathy was made and sodium correction was done with 3% saline and fludrocortisone. She responded well to therapy. The cause of hyponatremia was considered renal tubular dysfunction together with elevated antidiuretic hormone level. Postoperatively, it is important to look for the development of salt-losing nephropathy.
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series Case Reports in Medicine
spelling doaj-art-b41b2833d6644ca0a3c9dbee0d9e639e2025-08-20T02:23:13ZengWileyCase Reports in Medicine1687-96271687-96352009-01-01200910.1155/2009/241283241283Development of Severe Hyponatremia due to Salt-Losing Nephropathy after Esophagectomy for Esophageal CancerKatsunobu Yoshioka0Minako Nishio1Soichi Sano2Katsunobu Sakurai3Keiko Yamagami4Yoshito Yamashita5Department of Internal Medicine, Osaka City General Hospital, Osaka 534-0021, JapanDepartment of Internal Medicine, Osaka City General Hospital, Osaka 534-0021, JapanDepartment of Internal Medicine, Osaka City General Hospital, Osaka 534-0021, JapanThe Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka 534-0021, JapanDepartment of Internal Medicine, Osaka City General Hospital, Osaka 534-0021, JapanThe Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka 534-0021, JapanA 72-year-old woman was admitted to our hospital for esophagectomy for esophageal cancer. On the third postoperative day, she developed polyuria (3.8 L/day), massive natriuresis, hyponatremia (112 mEq/L), hyperkalemia (5.6 mEq/L), and decreased central venous pressure, which was refractory to isotonic saline infusion. Laboratory findings indicated proximal tubular injury (high urinary β2-microglobulin, coexistence of hypouricemia) together with reduced aldosterone action at the cortical collecting duct. A diagnosis of salt-losing nephropathy was made and sodium correction was done with 3% saline and fludrocortisone. She responded well to therapy. The cause of hyponatremia was considered renal tubular dysfunction together with elevated antidiuretic hormone level. Postoperatively, it is important to look for the development of salt-losing nephropathy.http://dx.doi.org/10.1155/2009/241283
spellingShingle Katsunobu Yoshioka
Minako Nishio
Soichi Sano
Katsunobu Sakurai
Keiko Yamagami
Yoshito Yamashita
Development of Severe Hyponatremia due to Salt-Losing Nephropathy after Esophagectomy for Esophageal Cancer
Case Reports in Medicine
title Development of Severe Hyponatremia due to Salt-Losing Nephropathy after Esophagectomy for Esophageal Cancer
title_full Development of Severe Hyponatremia due to Salt-Losing Nephropathy after Esophagectomy for Esophageal Cancer
title_fullStr Development of Severe Hyponatremia due to Salt-Losing Nephropathy after Esophagectomy for Esophageal Cancer
title_full_unstemmed Development of Severe Hyponatremia due to Salt-Losing Nephropathy after Esophagectomy for Esophageal Cancer
title_short Development of Severe Hyponatremia due to Salt-Losing Nephropathy after Esophagectomy for Esophageal Cancer
title_sort development of severe hyponatremia due to salt losing nephropathy after esophagectomy for esophageal cancer
url http://dx.doi.org/10.1155/2009/241283
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