A 60-year-old male with a history of morbid obesity (BMI 47 kg/m2), hypertension, type 2 DM, obstructive sleep apnea syndrome (OSAS), hypercholesterolemia and ischemic heart disease type transcatheter coronary infarction treated with 2 stents.
She was referred to surgery for bariatric surgery, laparoscopic tubular gastrectomy technique.
At discharge, treatment included amipryl 10 mg/24 hours, bisoprolol/hydrochlorothiazide 10/25 mg/24 hours, atorvastatin 10 mg/24 hours, barniline 20 mg/24 hours and metformin 1/8 hours.
After the intervention, the patient reported a low caloric intake, occasional episodes of dizziness and loss of 20 kg of weight in one month.
The progressive clinical worsening and the association of diarrheic syndrome came to the emergency department, where she found poor general condition, malaise, dry skin and mucous membranes, and blood pressure (BP) 92.
Blood tests were performed: glucose 214 mg/dl, urea 403 mg/dl, creatinine (Cr) 9.2 mg/dl, Na 151 mmol/l, Cl 113 mmol/l, K 4 mmol/l, bicarbonate 18dl
She was admitted to Nephrology with the diagnosis of prerenal ARF, hypernatremia and urinary infection. Antibiotic treatment and controlled electrolyte replacement were initiated with good response, with creatinine at discharge of 0.86 mg/dl.
