[Multiorgan dysfunction syndrome complicating hyperosmolar hyperglycemic syndrome as the primary feature of juvenile diabetes].

Diabetic ketotic acidosis and hyperosmolar hyperglycemic syndrome are regarded as the most serious diabetes complications. Acute renal failure frequently develops simultaneously with the symptoms of multiorgan disfunction and might be a factor indicating the severity of the primary disease. Authors present a case of a 11-year-old boy with acute renal failure due to defective perfusion and disseminated intravascular coagulation as the complications of hyperosmolar hyperglycemic syndrome. This syndrome was the first feature of juvenile diabetes. Intensive treatment of fluid and electrolyte disorders, mechanic ventilation, renal replacement therapy, and close collaboration of trained nephrologist with intensive care unit specialists allowed to cure critical health states and improve the course of diabetes.