89-year-old man with severe kidney failure due to prostate enlargement

The old man was hospitalized urgently due to urinary obstruction, body swelling, and was diagnosed with severe kidney failure due to an enlarged prostate.

Patient Dang Cuc (89 years old, Hanoi ) was admitted to Tam Anh General Hospital in Hanoi in early June due to being unable to walk, swelling and pain in both legs, abdominal distension accompanied by fatigue, and decreased urination.

Dr. Mai Thi Hien, Deputy Head of the Department of Urology - Andrology and Nephrology, said that the patient had severe kidney failure with a very high creatinine index of 1020 µmol/l (the index in normal people is around 100 µmol/l), with hyperkalemia. Ultrasound images showed an enlarged prostate, weighing 82 g.

The doctor promptly inserted a urinary catheter to help the patient relieve the obstruction, and at the same time treated him with medications and intravenous fluids to help correct the electrolyte imbalance. After a day, the patient urinated a lot, about 9 liters, improved symptoms of edema and bloating, felt comfortable, and had a good appetite. Blood tests showed that kidney function improved significantly, and creatinine levels decreased sharply.

Dr. Mai Thi Hien examines a patient during treatment at Tam Anh General Hospital. Photo: BVCC — Dr. Mai Thi Hien examines a patient during treatment at Tam Anh General Hospital. Photo: *BVCC*

Mr. Cuc said that he had previously taken blood pressure medication and prostate medication without a doctor's prescription or examination. According to Dr. Hien, taking medication without a prescription and an enlarged prostate are the causes of urinary tract obstruction leading to acute kidney failure. An enlarged prostate causes urinary tract obstruction, causing urine to stagnate in the bladder, increasing pressure in the renal tubules, causing hormonal changes leading to decreased blood flow through the kidneys, damage to renal tubular cells, and impaired absorption of water and salt, resulting in acute kidney failure.

After recovering and urinating again, the patient may continue to be in danger due to dehydration in the cells, electrolyte disturbances due to salt loss, potassium loss. Therefore, the patient continues to receive intravenous fluids, closely monitor blood pressure, weight as well as kidney function tests and blood electrolytes. After 3 days of active treatment, the patient's kidney function is completely restored. The patient can eat well, sleep well, and blood pressure is stable.

After being discharged from the hospital, Mr. Cuc continued to take medication to treat his illness, reduce uric acid, reduce blood pressure, and avoid taking medication not prescribed by a doctor. At the same time, he needed to have regular health check-ups to promptly detect dangerous signs for effective treatment.

According to Dr. Hien, prostate enlargement is a common disease in older men. In the world , about 60% of men over the age of 60 have benign prostatic hyperplasia, leading to urinary disorders that affect the quality of life. In the elderly, prostate enlargement can lead to dangerous complications such as acute renal failure, affecting life. Therefore, the elderly should have regular check-ups, detect the disease and treat it promptly to avoid serious complications, live long and healthy lives.

Luc Bao

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