Esprit Don H, Koratala Abhilash, Chornyy Volodymyr, Wingo Charles S
Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, FL.
Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, FL.
Urology. 2017 Mar;101:e9-e10. doi: 10.1016/j.urology.2016.11.041. Epub 2016 Dec 21.
Urinary tract obstruction leading to acute kidney injury is usually associated with bilateral hydroureters and hydronephrosis, often accompanied by oliguria. We present an atypical case of obstructive uropathy without these features that presented with severe acute kidney injury. A 64-year-old male with no known medical history has presented with a 2-week history of nausea, decreased appetite, flank pain, and lower extremity edema, and was found to have an elevated creatinine of 10.5 mg/dL. Renal ultrasound showed mild prominence of the bilateral renal collecting systems with no evidence of hydronephrosis. Computed tomography scan showed findings suggestive of retroperitoneal fibrosis involving ureteral region and bilateral ureteral stent placement has led to dramatic improvement of creatinine to 1.3 mg/dL over the next 4 days.
导致急性肾损伤的尿路梗阻通常与双侧输尿管积水和肾积水相关，常伴有少尿。我们报告一例非典型梗阻性肾病病例，该病例无上述特征，却出现了严重急性肾损伤。一名64岁男性，无已知病史，出现恶心、食欲减退、胁腹痛和下肢水肿2周，肌酐水平升至10.5mg/dL。肾脏超声显示双侧肾集合系统轻度突出，无肾积水迹象。计算机断层扫描显示结果提示腹膜后纤维化累及输尿管区域，双侧输尿管支架置入后，肌酐在接下来4天内显著改善至1.3mg/dL。
