Pediatric Nephrology Expert Opines on Delayed Treatment of Renal Failure

Case Overview

This case involves a 10-year-old boy who presented to the ER with complaints of nausea, vomiting, fever, and swelling of his lower limbs. The patient was discharged with over the counter painkillers as well as instructions to maintain fluid intake. The patient returned to the ER several days later with complaints of the same symptoms. At this point, he was admitted and treated for apparent dehydration with IV fluids. Due to a clerical mistake made by hospital staff, the patient was overloaded with fluid, and was given diuretics to correct this. A short time later, the patient was seen by a pediatric nephrologist who diagnosed him with syndrome of inappropriate antidiuretic hormone secretion, in which abnormal hormone levels cause the body to retain excess water. Later, the patient was also diagnosed with, and treated for, compartment syndrome. Despite treatment, the patient expired while in the hospital, and an autopsy determined the cause of death to be acute renal failure.