scholarly journals Retroperitoneal Fibrosis: A Rare Cause of Acute Renal Failure

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Amaka Ezimora ◽  
Marquetta L. Faulkner ◽  
Oluwafisayo Adebiyi ◽  
Abimbola Ogungbemile ◽  
Salas-Vega Marianna ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Ct Scan ◽  
Retroperitoneal Fibrosis ◽  
Incidental Finding ◽  
Obstructive Uropathy ◽  
Urine Volume ◽  
Fine Needle Biopsy ◽  
Renal Ultrasound ◽  
Significant Past Medical History

Introduction. Retroperitoneal fibrosis is a rare cause of acute renal failure (ARF) with only a handful of cases reported in literature. We report a case of a 40-year-old male with an incidental finding of retroperitoneal fibrosis.Case Presentation. Patient is a 40-year-old African American male with no significant past medical history who presented with a four-month history of low back pain and associated nausea with vomiting. Physical examination was significant for elevated blood pressure at 169/107 mmhg and bilateral pedal edema. Significant admission laboratory include blood urea nitrogen (BUN) of 108 mg/dL, serum creatinine (Cr) of 23 mg/dL, bicarbonate of 19 mg/dL, and potassium of 6.2 mmL/L. Renal ultrasound showed bilateral hydronephrosis. Post-void residual urine volume was normal. Abdominopelvic CT scan showed retroperitoneal fibrosis confirmed with fine-needle biopsy. He was treated with a combination of bilateral ureteral stent placement, hemodialysis, and steroid therapy. Four months after hospital discharge, his BUN and Cr levels Improved to 18 mg/dL and 1.25 mg/dL, respectively.Conclusion. Retroperitoneal fibrosis should be considered as a differential diagnosis in patients with acute renal failure and obstructive uropathy. Abdominal CT scan is the examination of choice for diagnosis. Full resolution with treatment depends on the duration of obstruction.

scholarly journals Ureteral Strangulation by Fibrosis: A Cold Case Report of Ormand's Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Amarpreet Sandhu ◽  
Leslea Brickner ◽  
Mark Chen
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Retroperitoneal Fibrosis ◽  
Obstructive Uropathy ◽  
Laboratory Data ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Renal Ultrasound ◽  
Idiopathic Retroperitoneal Fibrosis ◽  
Acute And Chronic Inflammation

Retroperitoneal fibrosis or Ormand's disease is rare in incidence and clinically elusive to diagnosis until obstructive uropathy clinically manifests by the mechanism of ureteral fibrotic strangulation and acute renal failure. We encountered a 50-year-old woman with months of nonspecific abdominal pain and presented with signs and symptoms of acute renal failure. Laboratory data was significant for blood urea nitrogen 47 mg/dL and creatinine of 8.47 mg/dL. Renal ultrasound revealed bilateral hydronephrosis and an abdominal computed tomogram confirmed an abnormal soft tissue retroperitoneal confluence that encased the pelvic vessels. Urologic consultation was requested and bilateral ureteral stents were placed with relief of her obstructive uropathy. Five days after ureteral stenting her creatinine dropped to 1.64 mg/dL. One month later patient underwent ureterolysis with biopsy showing fibroblast proliferation consistent with acute and chronic inflammation. By ruling out infections and malignancy, the final diagnosis was made to be idiopathic retroperitoneal fibrosis.

scholarly journals A rare cause of acute post renal failure: Retroperitoneal fibrosis

2017 ◽  
Vol 89 (4) ◽  
pp. 301
Author(s):  
Kamil Gokhan Seker ◽  
Mithat Eksi ◽  
Yunus Colakoglu ◽  
Mustafa Gürkan Yenice ◽  
Fatih Gokhan Akbay ◽  
...  
Keyword(s):  
Emergency Department ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Differential Diagnosis ◽  
Inflammatory Process ◽  
Emergency Services ◽  
Retroperitoneal Fibrosis ◽  
Obstructive Uropathy

Retroperitoneal fibrosis is an inflammatory process which may cause acute renal failure. In patients who admitted to emergency services with obstructive uropathy, retroperitoneal fibrosis should be considered in the differential diagnosis. We present our ten cases who admitted to emergency department with obstructive acute renal failure related to retroperitoneal fibrosis.

CONSERVATIVE MANAGEMENT OF ACUTE RENAL FAILURE

PEDIATRICS ◽  
1960 ◽  
Vol 25 (3) ◽  
pp. 409-418
Author(s):  
S. A. Kaplan ◽  
J. Strauss ◽  
A. M. Yuceoglu
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Fluid Intake ◽  
Sodium Intake ◽  
Caloric Intake ◽  
Urine Volume ◽  
Proximal Tubules ◽  
Cation Exchange Resins ◽  
Exchange Resins ◽  
Insensible Loss

The observations during treatment of three children with acute renal failure by a conservative regimen of therapy are presented. One patient died. The regimen has also been applied to six adults with renal failure; one died. The urine in the early stages of renal failure may be iso-osmotic with plasma and may represent unmodified fluid from the proximal tubules. Cardiac failure associated with hyperkalemia or administration of excessive quantities of fluids is the most frequent cause of death in this disorder. A regimen of therapy is described which embodies the following principles: a) Limitation of daily fluid intake to insensible loss plus the urine volume of the previous day. b) Restriction of sodium intake from the beginning to anticipate the development of acidosis. c) Use of cation exchange resins to prevent excessive increase in the concentration of potassium in the serum. d) Provision of adequate caloric intake through the administration of emulsified fat intravenously. e) Treatment of hyperphosphatemia and hypocalcemia when they occur. f) Continuation of careful supervision and therapy, even after the diuretic phase begins, since renal function continues to be severely restricted for several days afterwards.

Xanthine lithiasis, nephrocalcinosis, and renal failure in a leukemia patient treated with allopurinol.

1987 ◽  
Vol 33 (12) ◽  
pp. 2314-2316 ◽  
Author(s):  
J L Potter ◽  
A A Silvidi
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Tumor Cell ◽  
Lymphoblastic Leukemia ◽  
Obstructive Uropathy ◽  
X Ray Diffraction ◽  
X Ray ◽  
Leukemia Patient ◽  
Similar Episode ◽  
Tumor Cell Lysis

Abstract An 11-year-old boy who presented in acute renal failure with significant increases of uric acid and phosphorus in his serum was discovered to have acute lymphoblastic leukemia. Five years later, he had a second and similar episode of acute renal failure, which was responsive to hemodialysis. After three months of daily therapy with allopurinol, a third and final episode of renal failure was unresponsive to peritoneal dialysis. Autopsy revealed an obstructive uropathy; focal nephrocalcinosis; and multiple, small, tan calculi in the calyces of both kidneys. Systemic cryptococcosis was also discovered. The stones, characterized by paper chromatography, electrophoresis, x-ray diffraction, and infrared spectroscopy, were 82% xanthine, 15% oxypurinol, and 3% hypoxanthine. We suggest that attention to the effects of accelerated tumor-cell lysis may protect renal function in patients with a large and drug-sensitive tumor cell load. Similarly, early detection of the fungal complications of leukemic therapy is an essential component of the treatment program.

scholarly journals Risk factors for death among critically ill patients with acute renal failure

2006 ◽  
Vol 124 (5) ◽  
pp. 257-263 ◽  
Author(s):  
Geraldo Bezerra da Silva Júnior ◽  
Elizabeth De Francesco Daher ◽  
Rosa Maria Salani Mota ◽  
Francisco Albano Menezes
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Mechanical Ventilation ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Liver Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Urine Volume

CONTEXT AND OBJECTIVE: Acute renal failure is a common medical problem, with a high mortality rate. The aim of this work was to investigate the risk factors for death among critically ill patients with acute renal failure. DESIGN AND SETTING: Retrospective cohort at the intensive care unit of Hospital Universitário Walter Cantídio, Fortaleza. METHODS: Survivors and non-survivors were compared. Univariate and multivariate analyses were performed to establish risk factors for death. RESULTS: Acute renal failure occurred in 128 patients (33.5%), with mean age of 49 ± 20 years (79 males; 62%). Death occurred in 80 (62.5%). The risk factors most frequently associated with death were hypotension, sepsis, nephrotoxic drug use, respiratory insufficiency, liver failure, hypovolemia, septic shock, multiple organ dysfunction, need for vasoactive drugs, need for mechanical ventilation, oliguria, hypoalbuminemia, metabolic acidosis and anemia. There were negative correlations between death and: prothrombin time, hematocrit, hemoglobin, systolic blood pressure, diastolic blood pressure, arterial pH, arterial bicarbonate and urine volume. From multivariate analysis, the independent risk factors for death were: need for mechanical ventilation (OR = 3.15; p = 0.03), hypotension (OR = 3.48; p = 0.02), liver failure (OR = 5.37; p = 0.02), low arterial bicarbonate (OR = 0.85; p = 0.005), oliguria (OR = 3.36; p = 0.009), vasopressor use (OR = 4.83; p = 0.004) and sepsis (OR = 6.14; p = 0.003). CONCLUSIONS: There are significant risk factors for death among patients with acute renal failure in intensive care units, which need to be identified at an early stage for early treatment.

DIAGNOSIS AND TREATMENT: ACUTE RENAL FAILURE

PEDIATRICS ◽  
1965 ◽  
Vol 35 (3) ◽  
pp. 478-481
Author(s):  
Malcolm A. Holliday
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Glomerular Filtration Rate ◽  
Renal Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Obstructive Uropathy ◽  
Urine Flow ◽  
Water Restriction ◽  
Plasma Electrolyte

ACUTE RENAL FAILURE is an uncommon emergency which faces pediatricians. It is usually easy to recognize. The management in the early phase is critical to the survival potential of the patient. The purpose of this review is to cite the causes, characteristics, and principally the management of acute renal failure. Renal failure is defined as a state in which there is not sufficient kidney function to prevent the development of severe uremia or to maintain plasma electrolyte values in a range compatible with ordinary activities. Clinically the condition is associated with mental confusion, stupor, and frequently convulsions. Persistent hiccoughs, irregular respirations, and muscle cramps also may occur. Usually though not always, there is obvious oliguria. Since urine flow is ordinarily but 0.2-2,0% of glomerular filtration rate, and since glomerular filtration rate reduction to 5-10% may be associated with uremia, it is possible to have renal failure without oliguria. It is also possible to have physiological oliguria (< 300 ml per square meter) in response to rigid water restriction that is not related to renal failure. Hence, the term must be defined in terms of its effect on plasma composition rather than in terms of urine flow. The presence of certain clinical conditions known to result in acute renal failure should alert the physician. These include: nephrotoxie agents; hemoglobinuria or myoglobinuria; shock with anoxic damage; acute, diffuse renal disease; acute dehydration in patients with chronic advanced renal disease; and acute obstructive uropathy. Nephrotoxic agents, hemoglobinuria, and shock all result in acute tubular necrosis, and recovery depends upon the capacity of the nephron to regenerate on an intact basement membrane.

Acute kidney injury

2018 ◽  
Author(s):  
Aron Chakera ◽  
William G. Herrington ◽  
Christopher A. O’Callaghan
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Urine Volume ◽  
Kidney Injury ◽  
Rapid Decrease

Acute renal failure (also referred to as acute kidney injury) refers to a rapid decrease in renal function; it is reflected by an increase in blood urea and creatinine and is often associated with oliguria (a urine volume of less than 400 ml/24 hours). It usually develops over days to weeks. Acute kidney injury has been variously classified, but the current classifications are based on the glomerular filtration rate (or creatinine), looking at changes from baseline, and the presence of oliguria or anuria. The potential etiologies of acute kidney injury are usually considered anatomically under the headings prerenal, renal (intrinsic), and postrenal. This chapter looks at the etiology, symptoms, clinical features, demographics, complications, diagnosis, and treatment of acute kidney injury.

Lesch-Nyhan syndrome presenting as acute renal failure secondary to obstructive uropathy

Urology ◽  
2000 ◽  
Vol 56 (6) ◽  
pp. 1056 ◽  
Author(s):  
MuralikK Ankem ◽  
David B Glazier ◽  
Joseph G Barone
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Obstructive Uropathy

Adenovirus-induced Obstructive Uropathy With Acute Renal Failure in an Immunodeficient Child

Urology ◽  
2014 ◽  
Vol 83 (1) ◽  
pp. 217-219 ◽  
Author(s):  
Ernesto Montaruli ◽  
Barbara E. Wildhaber ◽  
Marc Ansari ◽  
Jacques Birraux
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Obstructive Uropathy
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