Tjahjadi Angela Kimberly, Tjempakasari Artaria
Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Acta Med Indones. 2024 Oct;56(4):519-526.
This report describes a rare case of anuric acute kidney injury related to suspected urate nephropathy in a 23-year-old male with chronic phase of Chronic Myeloid Leukemia (CML). The patient presented with anuria and limb edema, with a history of imatinib-treated CML. Investigations revealed probable urate crystals causing bilateral hydronephrosis and hydroureters. Management included fluid restriction to maintain euvolemic status, hypouricemic agents, urinary alkalinization, urgent hemodialysis for acute kidney injury, and blood product transfusions to address haematological imbalances. The continued use of imatinib and aforementioned treatments resulted in the restoration of renal function depicted through normalization of serum urea, creatinine and uric acid levels. This case highlights the importance of meticulous assessment and management of anuric acute kidney injury in CML patients to ensure a positive outcome.
本报告描述了一名23岁慢性粒细胞白血病(CML)慢性期男性患者,疑似因尿酸盐肾病导致无尿性急性肾损伤的罕见病例。该患者表现为无尿和肢体水肿,有伊马替尼治疗CML的病史。检查发现可能是尿酸盐结晶导致双侧肾盂积水和输尿管积水。治疗措施包括限制液体摄入以维持血容量正常状态、使用降尿酸药物、碱化尿液、针对急性肾损伤进行紧急血液透析以及输注血液制品以纠正血液学失衡。继续使用伊马替尼及上述治疗使肾功能得以恢复,表现为血清尿素、肌酐和尿酸水平恢复正常。该病例强调了对CML患者无尿性急性肾损伤进行细致评估和管理以确保良好预后的重要性。