[Acute renal failure in a prisoner after hunger strike].
BACKGROUND
Acute renal failure may occur in varied circumstances. It is potentially reversible spontaneously or after specific treatment. It is rare after hunger strike and fewer cases were reported in the literature. The physiopathological mechanisms are varied and remain incompletely known.


OBJECTIVE
We report the case of a prisoner having presented an acute renal failure after a hunger strike wich was completely reversible.


METHODS
He's a 29 year old man, without a past medical facts, in July 2004 he was incarcereted in prison. In October 2004 he undertake a hunger strike during one month. In November 2004 he was hospitalized for global dehydration and shock. His physical examination showed blood pressure 60/40 mmHg, weight 59 Kg with a loss of weight about 10 Kg, diuresis 800 cc/day. His biological findings showed urea 100 mmol/l, creatinemia 679 (mo/l, natremia 179 mmol/l, kaliemia 5 mmol/l, glycemia 5.2 mmol/l, albuminemia 35 g/l, calcemia 2.35 mmol/l and biological marques of rhabdomyolysis: CPK at 11 times the normal and LDH two times the normal. His treatment consisted on rehydratation, parenteral then enteral refeeding and psychiatric talks. The evolution was favourable, re-establishment of good hydration state with a gain weight of 7 Kg, normalization of renal function, his creatininemia reached 85 (mol/l in three weeks and normalization of muscles enzymes in one month.


CONCLUSIONS
Hunger strike continue to pose a problem because of it's frequency in penitentiary structures and its organic disorders which can lead to death. A good psychiatric cares may be undertaked in order to prevent a such bad manifestations.
Service de Néphrologie et de Médecine Interne A Hôpital Charles Nicolle, Tunis, Tunisie.
Imène
I
Gorsane
Karim
K
Zouaghi
Rim
R
Goucha
Fethi
F
El Younsi
Hafedh
H
Hedri
Samia
S
Barbouch
Taïeb
T
Ben Abdallah
Fatma
F
Ben Moussa
Hedi
H
Ben Maiz
Adel
A
Kheder
D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy; D000328:Adult; D034462:Dissent and Disputes; D006801:Humans; D006815:Hunger; D008297:Male; D018529:Nutritional Support; D011329:Prisoners; D015532:Rehydration Solutions / Q000627:therapeutic use; D013217:Starvation / Q000150:complications*
D015532:Rehydration Solutions