A patient has gradually lost his consciousness. The skin is pale and dry. There is smell of ammonia from the mouth. Respirations are deep and noisy. Heart sounds are muffled, pericardial friction rub is present. Blood pressure is 180/130mm Hg. Blood test: Hb — 80 g/L, leukocytes — 12 • 109/L, blood glucose — 6.4mmol/L, urea — 50 mmol/L, creatinine — 1200 mcmol/L, blood osmolarity —350 mOsmol/kg H20. No urinary excretion. Make the diagnosis: