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February 1960

Hyperosmolarity (Hypernatremia) and Azotemia Induced by the Administration of Urea

Author Affiliations

San Francisco
From the Division of Neurological Surgery, University of California Medical Center.

AMA Arch Neurol. 1960;2(2):160-162. doi:10.1001/archneur.1960.03840080046008

Urea has proved to be a useful agent in lowering intracranial pressure and brain bulk.1,2 This agent has generally been administered intravenously in a 30% solution. Urea has been administered orally in repeated daily doses for several weeks and, in a few instances, for several months.3

In the case to be described, urea was administered by gastric tube in amounts of 150 to 400 ml. of 30% solution for eight days. The osmotic diuresis which occurred appears to have been responsible for the hyperosmolarity and azotemia which developed.

Report of a Case  A 70-year-old woman, left-handed, began to have convulsive seizures in 1948. One year later she underwent a laparotomy for exploration of the common bile duct. She developed a vascular collapse during the procedure and remained in coma for two days following the operation. When she recovered, she had total amaurosis of the left eye. In retrospect