Acute renal failure in diabetes: looking beyond diabetic retinopathy.

摘要

A 43-year-old construction worker was admitted to the emergency department with increasingly severe right-sided abdominal pain of three days' duration. There had been no precipitant injury and it had not improved with regular ibuprofen. He had type 1 diabetes of 20 years' duration treated with once daily basal glargine and mealtime NovoRapid~R insulin. Other medications were simvastatin 80 mg od, losartan 25 mg od and perindopril 4 mg od. His complications of diabetes included bilateral photocoagulation-treated retinopathy but no known peripheral neuropathy or nephropathy. He also had hypertension, smoked 10 cigarettes daily and had a pleurodesis procedure following a pleural drain for a parapneumonic effusion five years previously.