Massive Reversible Prerenal Azotemia

Abstract

To the Editor. —We saw a patient with transient excessively high urea levels presumably resulting from starvation and dehydration. Report of a Case. —A 68-year-old hypertensive man was seen initially in July 1980 with severe pulmonary edema in association with acute myocardial infarction. The patient's hospital course was normal, except for moderate renal failure (ie, a serum urea level of 73 mg/dL, a serum creatinine level of 2.4 mg/dL, and a serum creatinine clearance of 40 mL/min). He was discharged from the hospital in satisfactory condition on a combined regimen of 0.25 mg of digoxin five times per week, 40 mg of oral furosemide every other day, and 750 mg of methyldopa per day. Three weeks later, the patient was readmitted to the hospital because of dramatic deterioration of his condition, with vomiting and confusion. The patient recalled that, shortly after being discharged, he had separated from his female companion