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Fainting, CT shows prostatomegaly and scar in urinary bladder. Am diabetic and hypertensive. Whom to consult?

my uncle aged 68 years who is a known diabetic, known hypertensive patient weighing 88 kg, he was admitted last week decause of a sudden fainting in the morning , on admission his potassium was 7, creatinine 3 , urea 65, and sodium 144,his thyroid function is normal, hb 10.1 and tc 5200 his echo was normal, usg and ct abdomen shows prostatomegaly and a scar in the urinary bladder , his kidneys are normal in size , till nw the patient has not complained about pain during micturation or any haematuria he is having a urine output of above 2000ml in 24hrs, to whom i should consult a nephrologist or a urologist ? please give me a relevent reply
Tue, 24 Jul 2012
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Internal Medicine Specialist 's  Response
Jan 2013
Hello & welcome to HCM forum

1) Your uncle is suffering from chronic kidney disease (as blood urea & creatinine is raised) and most likely benign hypertrophy of prostate (as defined by you).

2) You have not mentioned that your uncle is passing urine himself or any urinary catheterization has been applied. If he is passing urine himself then there is least chance of obstructive uropathy as he is passing 2 liters urine in 24 hours.

3) There is high chances of CKD as serum potassium and Renal Function test are deranged and diabetes is also a major culprit disease for CKD world wide (2nd most common disease is hypertension)

4) You should consult Nephrologist (as urea & creatinine, potassium are deranged) as well as urologist (as he has prostatomegaly).

5) Fainting attacks may due to stroke or Uraemic encephalopathy.

Get well soon & wishing for rapid recovery

Dr. Mayank Bhargava
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