What causes hiccups and low output of urine after an ischemic stroke?
Patient: Hi. My father is the patient. he s 80 yrs old and had a stroke 5 months ago-he was diagnosed with an ischaemic stroke. Comorbidities are: hypertension, diabetes mellitus and prostate cancer. he s currently discharged from the hospital. he s been having very high blood pressures at night like 194/90 and during the day, especially when we sit him down, it falls so low like 90/70 for about a month now. he also started having seizures some weeks ago, about once a week and now, for the past two days, he s been vomitting. his urine is also highly concentrated and sometimes in a day, urine output is less than 100mls. his appetite has also declined and he s lethargic with lots of hiccups. can you please tell me what is happening? Doctor: Hi,  Low urine output and hiccups, vomitings suggest uremia/renal failure; need to know BUN, serum creatinine, serum electrolytes and urinalysis report apart from full blood count. He is also having postural hypotension from lying to sitting position (lying to standing -more sensitive but lying to sitting is sometimes all that is possible for a less mobile patient).   Prolonged bed rest and chronic hypertension (decreased baroreflex sensitivity and LV compliance) and? drug and diabetes (autonomic neuropathy) could be the cause. He may require renal replacement therapy.  Hope I have answered your query. Let me know if I can assist you further.  Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist