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83-Year-Old Man With Chronic Kidney Disease, Fluid Overload, and Coronary Artery Disease Develops Altered Mental Status

Brett C. Bade, MD; Sean P. Callahan, MD; Jean Paul Higuero, MD; Nicholas Pastis, MD; John Terrill Huggins, MD
Author and Funding Information

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC

CORRESPONDENCE TO: John Terrill Huggins, MD, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, 96 Jonathan Lucas St, Ste 812-CSB, MSC 630, Charleston, SC 29425-6300


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4):e111-e114. doi:10.1016/j.chest.2015.11.032
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An 83-year-old man with a history of chronic kidney disease (stage V) as a result of hypertensive nephrosclerosis and coronary artery disease was admitted to the hospital with dyspnea and bilateral lower extremity edema. Owing to oliguria and progressive renal dysfunction, hemodialysis was initiated the following day via a previously-placed left arm arteriovenous fistula. As a result of delirium and bradycardia, he required prolonged hospitalization. Three weeks into his course, he became hypothermic and obtunded.

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