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一名医源性无尿超过300天的心脏移植受者肾功能的恢复:病例报告

Recovery of renal function in a heart transplantation recipient with over 300 days of iatrogenic anuria: A case report.

作者信息

Peng Yong-Hua, Yu Xiao-Min, Yan Chen, Luo Lan, Li Tao-Sheng, Xiao Jie

机构信息

Department of Nephrology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou.

Department of Stem Cell Biology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

出版信息

Medicine (Baltimore). 2018 Apr;97(17):e0451. doi: 10.1097/MD.0000000000010451.

Abstract

RATIONALE

Anuria is a severe symptom indicating severe kidney damage. Patient recovery from prolonged anuria is rarely reported.

PATIENT CONCERNS

A 15-year-old boy received gender- and weight-mismatch heart transplantation (HT) due to dilated cardiomyopathy. He developed severe hypotension, and heart failure 24 hours after surgery, which were relieved by preload reduction treatments. Although, routine examinations did not show any abnormalities in renal function before surgery, anuria occurred 4 days after preload reduction treatments (24-hour urine volume was 23 mL).

DIAGNOSIS

The patient was diagnosed with acute kidney injury (AKI).

INTERVENTIONS

He was admitted to continuous renal replacement therapy (CRRT) or hemodialysis.

OUTCOMES

Surprisingly, his urine volume was gradually, and miraculously, restored to more than 1000 mL/24 hours after over 300 days of anuria. Hemodialysis was not needed in the twentieth month after surgery. Moreover, he partially, recovered renal function.

LESSONS

This case indicates the likelihood of recovery from long-term anuria.

摘要

理论依据

无尿是一种严重症状,提示严重的肾脏损害。很少有关于长期无尿患者康复的报道。

患者情况

一名15岁男孩因扩张型心肌病接受了性别和体重不匹配的心脏移植(HT)。术后24小时,他出现了严重的低血压和心力衰竭,通过减少前负荷治疗得以缓解。尽管术前常规检查未显示肾功能有任何异常,但在减少前负荷治疗4天后出现了无尿(24小时尿量为23毫升)。

诊断

该患者被诊断为急性肾损伤(AKI)。

干预措施

他接受了连续性肾脏替代治疗(CRRT)或血液透析。

结果

令人惊讶的是,在无尿超过300天后,他的尿量逐渐且神奇地恢复到超过1000毫升/24小时。术后第20个月不再需要血液透析。此外,他的肾功能部分恢复。

经验教训

该病例表明长期无尿有恢复的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59f5/5944477/e5dc52c0db79/medi-97-e0451-g001.jpg

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