Acute Renal Failure Secondary to Tuberculosis: A Diagnostic Challenge

Tuberculosis is a multiorgan disease with varied clinical presentations and is reemerging due to increasing immigration and globalization. We present the case of an immigrant female patient who developed acute renal failure with clinical and biochemical features suggestive of lupus nephritis but with a timely renal biopsy showing caseating granulomata in the renal parenchyma consistent with renal tuberculosis. Despite treatment with antituberculosis treatment and resolution of TB on repeat renal biopsy, she remained haemodialysis dependent. We discuss the diagnostic challenges faced in this presentation and also explore possible differential diagnoses. This rare presentation highlights the importance of renal biopsy in the diagnosis and treatment of acute renal failure and the atypical presentation of tuberculosis.

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Infective endocarditis associated with acute renal failure: Repeat renal biopsy and successful recovery

Experimental and Therapeutic Medicine ◽

10.3892/etm_00000067 ◽

2010 ◽

Vol 1 (3) ◽

pp. 433-436 ◽

Cited By ~ 4

Author(s):

AIFENG WANG ◽

YONGPING WANG ◽

GUOBAO WANG ◽

ZHANMEI ZHOU ◽

XIAOBING YANG

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Infective Endocarditis ◽

Renal Biopsy ◽

Successful Recovery ◽

Repeat Renal Biopsy

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Serial renal biopsy findings in a case of POEMS syndrome with recurrent acute renal failure

Clinical and Experimental Nephrology ◽

10.1007/s10157-011-0540-z ◽

2011 ◽

Vol 16 (1) ◽

pp. 173-179 ◽

Cited By ~ 7

Author(s):

Atsuko Y. Higashi ◽

Fumiaki Nogaki ◽

Isoroku Kato ◽

Takahiko Ono ◽

Atsushi Fukatsu

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Renal Biopsy ◽

Poems Syndrome

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Renal Biopsy in Acute Renal Failure: Its Indications and Usefulness

Acute Renal Failure ◽

10.1007/978-1-4613-2841-4_8 ◽

1984 ◽

pp. 201-204

Author(s):

Olivier Kourilsky ◽

Liliane Morel-Maroger ◽

Gabriel Richet

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Renal Biopsy

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Acute Renal Failure Due to Interstitial Nephritis Induced by ‘Glue-Sniffing’ with Subsequent Recovery

Scottish Medical Journal ◽

10.1177/003693308803300208 ◽

1988 ◽

Vol 33 (2) ◽

pp. 246-247 ◽

Cited By ~ 11

Author(s):

D. Taverner ◽

D.J. Harrison ◽

G.M. Bell

Keyword(s):

Renal Failure ◽

Renal Function ◽

Acute Renal Failure ◽

Renal Biopsy ◽

Interstitial Nephritis ◽

Hepatic Damage ◽

Subsequent Recovery ◽

Renal Complications ◽

Toluene Exposure

We report a case of the deliberate inhalation of a toluene-containing adhesive which caused acute renal failure and hepatic damage. Renal biopsy disclosed a severe tubulo-interstitial nephritis, renal function recovered after 14 days' haemodialysis. The literature on renal complications of toluene exposure is reviewed, this is the only case of acute renal failure due to interstitial nephritis after toluene exposure with subsequent recovery. Recovery in this case may have been related to the avoidance of further toluene exposure.

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Renal Biopsy Findings in Acute Renal Failure in the Cohort of Patients in the Spanish Registry of Glomerulonephritis

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.04441007 ◽

2008 ◽

Vol 3 (3) ◽

pp. 674-681 ◽

Cited By ~ 38

Author(s):

Juan M. López-Gómez ◽

Francisco Rivera

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Renal Biopsy

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Case Report: Renal Tubular Acidosis, Hypokalemic Paralysis, Rhabdomyolysis, and Acute Renal Failure - A Rare Presentation of Chinese Herbal Nephropathy

Renal Failure ◽

10.3109/08860229909066988 ◽

1999 ◽

Vol 21 (2) ◽

pp. 227-230 ◽

Cited By ~ 13

Author(s):

Chien-Te Lee ◽

Mai-Szu Wu ◽

Kang Lu ◽

Kuo-Tai Hsu

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Case Report ◽

Renal Tubular Acidosis ◽

Rare Presentation ◽

Hypokalemic Paralysis ◽

Chinese Herbal ◽

Renal Tubular

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Addison’s Disease Presenting as Acute Renal Failure and Hyperkalemic Paralysis: A Rare Presentation

Case Reports in Endocrinology ◽

10.1155/2021/3103011 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Kundan Jana ◽

Kalyana Janga ◽

Sheldon Greenberg ◽

Amit Gulati

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Adrenal Insufficiency ◽

Delayed Diagnosis ◽

Kidney Injury ◽

Addison’S Disease ◽

Adrenal Crisis ◽

Addison's Disease ◽

Medication History ◽

Rare Presentation

Hyperkalemic paralysis in the setting of acute renal failure can lead to a missed or delayed diagnosis of adrenal insufficiency as the raised potassium can be attributed to the renal failure. Acute kidney injury as the presenting manifestation in an adrenal crisis due to Addison’s disease has been rarely reported in the literature. Here, we present the case of a young 37-year-old male who came with hyperkalemic paralysis and acute renal failure needing emergent hemodialysis. He had no past medical history and no medication history. His hyponatremia, hypotension, and hyperkalemia pointed to a picture of adrenal insufficiency confirmed by undetectable serum cortisol, elevated ACTH, renin, and low aldosterone levels and imaging. Replacement steroid therapy was given, and the patient made a steady recovery. He was advised on the importance of compliance to treatment at discharge to prevent another crisis event. Acute renal failure with hyperkalemia as a presenting manifestation of Addison’s disease can be very misleading. It is especially important to be vigilant of adrenal insufficiency in such patients as the hyperkalemia is resistant to standard therapy of insulin dextrose and can precipitate fatal arrhythmia if treatment is delayed.

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