scholarly journals Bilateral Spontaneous Perirenal Hemorrhage in an Acquired Cystic Kidney Disease Hemodialysis Patient

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Daigoro Hirohama ◽  
Hiroshi Miyakawa
Keyword(s):  
Kidney Disease ◽  
Renal Artery ◽  
Rare Complication ◽  
Artery Aneurysm ◽  
Arterial Embolization ◽  
Aneurysm Rupture ◽  
Cystic Kidney Disease ◽  
Cystic Kidney ◽  
Acquired Cystic Kidney Disease ◽  
Perirenal Hemorrhage

Acquired cystic kidney disease (ACKD) is a well-known late stage complication of chronic kidney disease. Cysts tend to grow with time on dialysis and could lead to malignant transformation, and intra- or perirenal hemorrhage is a rare complication of ACKD. Here we describe one case of bilateral spontaneous perirenal hemorrhage of ACKD in a 44-year-old man, on hemodialysis for 15 years. One was due to cyst rupture, and the other was due to aneurism rupture, both were controlled with transcatheter arterial embolization. In renal arteriography at the second rupture, we demonstrated extravasation from an aneurysm being present at the periphery of right renal artery. Several spontaneous perirenal hemorrhage cases were reported but its clinical information is limited, moreover, bilateral cases were extremely rare. Furthermore, to our knowledge, this is the first report of spontaneous perirenal hemorrhage caused by intraparenchymal renal artery aneurysm rupture in ACKD patients. We report this case because of its rarity and significance with respect to the complication of dialysis patients, review reported bilateral cases, and discuss some clinical characteristics.

scholarly journals Renal artery embolization for spontaneous hemorrhage in patients with acquired cystic kidney disease: A 20-year single-center experience

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Cheng Shi Chen ◽  
Hyemin Ahn ◽  
Ji Hoon Shin ◽  
Hai-Liang Li ◽  
Jong Woo Kim ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Renal Artery ◽  
Cystic Kidney Disease ◽  
Cystic Kidney ◽  
Artery Embolization ◽  
Contrast Extravasation ◽  
Spontaneous Hemorrhage ◽  
Single Center Experience ◽  
Acquired Cystic Kidney Disease ◽  
Renal Artery Embolization

Objectives: To evaluate the safety and effectiveness of transcatheter arterial embolization for controlling spontaneous hemorrhage in patients with acquired cystic kidney disease (ACKD). Methods: This retrospective study included 18 patients with ACKD (M:F=13:5; mean age, 56 years) who underwent renal artery embolization to control spontaneous hemorrhage between January 2001 and September 2020. The underlying etiology and clinical presentations were reviewed and previous computed tomography (CT) findings were analyzed. Furthermore, angiographic and embolization details, technical and clinical successes, and complications were assessed. Results: Subcapsular, perirenal, and pararenal hematomas were observed on CT scans for all patients. Contrast extravasation was observed in 15 / 17 patients (88%) on contrast-enhanced CT scans. Angiography showed active bleeding in 14 patients (78%; contrast extravasation [n=6], pseudoaneurysm [n=3], and both [n=5]), suspicious bleeding in 1 (5%), and no bleeding in 3 (17%). The technical and clinical success rates were 100% and 94% (17/18), respectively. Total and partial embolization was performed in 14 (78%) and 4 (22%) cases, respectively. Subsequent surgical nephrectomy was required for one patient with clinical failure due to recurrent bleeding despite total embolization. Procedure-related complications included mild post-embolization syndrome in one patient and contrast-induced nephropathy in five patients (28%) without long-term complications. Conclusions: Renal artery embolization is safe and effective for controlling spontaneous renal hemorrhage in patients with ACKD. doi: https://doi.org/10.12669/pjms.37.4.3999 How to cite this:Chen CS, Ahn H, Shin JH, Li HL, Kim JW, Ibrahim A, et al. Renal artery embolization for spontaneous hemorrhage in patients with acquired cystic kidney disease: A 20-year single-center experience. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.3999 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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