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

2019 ◽  
Vol 1 (4) ◽  
pp. 1-4
Author(s):  
Yılmaz Omer ◽  
Kizilkan Yunus Emre ◽  
Temel Muhammed Cihan ◽  
Ediz Caner ◽  
Ozcelik Fatih
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Retroperitoneal Fibrosis ◽  
Foley Catheter ◽  
Idiopathic Retroperitoneal Fibrosis ◽  
Fibrotic Tissue ◽  
Abdominal Magnetic Resonance Imaging ◽  
Grade 3 ◽  
Loss Of Appetite

Idiopathic retroperitoneal fibrosis also known as Ormonds disease is a rare disorder characterized by the development of fibrotic tissue in the retroperitoneum. The fibrotic tissue may compress ureters, leading to obstructive nephrouropathy and renal failure. A 58-year-old man with fatigue, loss of appetite and unable to urinate was admitted to our clinic. Because of the serum creatinine value of 5.3 mg/dl, urinary ultrasonography was performed and bilateral grade 3 hydronephrosis with moderate level urine in bladder was detected. Hydronephrosis did not regress by transurethral foley catheter and suspicious appearance in the retroperitoneal area was found in abdominal magnetic resonance imaging. Tru-cut biopsy result of the current lesion was finally reported as a connective tissue. Bilateral double j catheter insertion was performed and started to immunosuppression therapy with corticosteroid. Two months later, double j catheters were removed and hydronephrosis was not detected in follow-up. In this case report, we tried to explain that, retroperitoneal fibrosis should be considered in the differential diagnosis of postrenal acute renal failure, even in patients without a classic symptom such as pain. In addition, early surgical intervention should be avoided in such patients.

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 Refractory Acute Interstitial Nephritis in the Setting of Nivolumab Therapy

2021 ◽  
Vol 2021 ◽  
pp. 1-4 ◽  
Author(s):  
Antonio Faieta ◽  
Tavis Dancik
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Interstitial Nephritis ◽  
Acute Interstitial Nephritis ◽  
Term Treatment ◽  
Steroid Dependent ◽  
Long Term Treatment ◽  
Grade 3

A 65-year-old male patient with metastatic CCRCC developed steroid-dependent, grade 3 AIN secondary to nivolumab weeks after its initiation that resulted in 3 hospitalizations with acute renal failure. The patient was started on MM and his AIN was successfully controlled after a 2-year period of follow-up. Refractory renal AIN resulting from PD-1 inhibitor use is rare, and its successful treatment with mofetil mycophenolate with a 2-year follow-up in a patient with metastatic CCRCC has not been reported. This case is important because not only was his renal irAEs controlled but also long-term treatment with MM did not result in progression of metastatic disease.

scholarly journals Characteristics of Adult Patients with Idiopathic Retroperitoneal Fibrosis and Assessment of Risk of Relapse at Diagnosis

2021 ◽  
Vol 10 (7) ◽  
pp. 1380
Author(s):  
Jerome Razanamahery ◽  
Bastien Bouldoires ◽  
Sebastien Humbert ◽  
Philip Bielefeld ◽  
Veronique Fournier ◽  
...  
Keyword(s):  
Renal Failure ◽  
Smoking Cessation ◽  
Chronic Renal Failure ◽  
Retroperitoneal Fibrosis ◽  
Adult Patients ◽  
Idiopathic Retroperitoneal Fibrosis ◽  
Multicentric Study ◽  
Radiological Features ◽  
Presentation Methods

Objectives: To compare adult patients’ characteristics suffering from idiopathic retroperitoneal fibrosis between “relapse-free” and relapsing patients at the diagnosis and identify factors associated with relapse at initial presentation. Methods: We conducted a retrospective multicentric study in four hospitals in Eastern France, from 1993 to 2020, of adult patients suffering from idiopathic retroperitoneal fibrosis. We analyzed clinical, biological, and radiological features at diagnosis and during a forty-month follow-up. Results: Of 47 patients suffering from retroperitoneal fibrosis, 21 patients had idiopathic retroperitoneal fibrosis. Among them, 13 experienced one or more relapses during follow-up. At diagnosis, clinical characteristics, relevant comorbidities, biological and radiological features were similar between groups. Smoking cessation seems associated with decreased relapse risk (p: 0.0624). A total of 8 patients developed chronic renal failure during follow-up. Ureteral infiltration at diagnosis was associated with evolution to chronic renal failure (p: 0.0091). Conclusion: No clinical, biological, or radiological features could predict relapse at retroperitoneal fibrosis diagnosis, but smoking cessation may prevent relapse.

Idiopathic Retroperitoneal Fibrosis Presenting with Hypertension and Acute Renal Failure

2017 ◽  
Vol 18 (1) ◽  
pp. 37-39
Author(s):  
Engin Onan ◽  
Saime Paydas ◽  
Merve Erkoc ◽  
Tuba Korkmaz ◽  
Hasan Bilen Onan ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Retroperitoneal Fibrosis ◽  
Idiopathic Retroperitoneal Fibrosis

scholarly journals Renal function following acute renal failure in childhood: A long term follow-up study

1989 ◽  
Vol 35 (1) ◽  
pp. 84-89 ◽  
Author(s):  
Helen N. Georgaki-Angelaki ◽  
David B. Steed ◽  
Cyril Chantler ◽  
George B. Haycock
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Follow Up Study ◽  
Long Term Follow Up

scholarly journals Idiopathic retroperitoneal fibrosis: A report on 15 patients

2015 ◽  
Vol 72 (10) ◽  
pp. 928-931 ◽  
Author(s):  
Jovan Hadzi-Djokic ◽  
Tomislav Pejcic ◽  
Dragoslav Basic ◽  
Ivana Vukomanovic ◽  
Zoran Dzamic ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Retroperitoneal Fibrosis ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Omental Flap ◽  
Definitive Treatment ◽  
Pathological Examination ◽  
Idiopathic Retroperitoneal Fibrosis ◽  
The Mean

Background/Aim. Retroperitoneal fibrosis (RPF) represents a chronic pathological process characterized by fibrosis which entraps and compresses the ureters and the great blood vessels in the retroperitoneal space. A specific form of RPF is idiopathic RPF, an uncommon collagen vascular disease of unclear etiology. The series of 15 patients which underwent open surgical repair due to idiopathic RPF is presented herein. Methods. From 1989 to 2012, 11 male and 4 female patients underwent surgery due to primary RPF. The ureters were entrapped unilaterally (7 patients), or bilaterally (8 patients). Major symptoms included low back pain due to hydronephrosis (9 patients), uremia (4 patients), and urinary tract infection (2 patients). The diagnosis was based on intravenous urography (IVU), retrograde ureteropyelography and computed tomography (CT). Results. Surgical procedures included intraperitoneal ureteral displacement (8 patients) and ureteral wrapping with omental flap (6 patients). One patient underwent bilateral ureteral stenotic segments resection and oblique ureterography, followed by wrapping with omental flap. Pathological examination confirmed primary RPF in all patients. The mean operative time was 3.5 h (range 2.5-4.5 h). The average intrahospital stay was 21 days (range 16-26 days). The mean follow up was 32 months (6-46 months). During the follow up, 12 patients had improvement on IVU. Conclusion. Early recognition of signs and symptoms of RPF is of the utmost importance for the outcome. Surgical procedures, including ureteral wrapping with omental flap, or intraperitoneal ureteral displacement, usually represent definitive treatment.

A 3-year follow-up of a patient with acute renal failure caused by thrombotic microangiopathy related to antiphospholipid syndrome: case report

Lupus ◽  
2016 ◽  
Vol 26 (7) ◽  
pp. 777-782 ◽  
Author(s):  
X-J Zhou ◽  
M Chen ◽  
S-X Wang ◽  
F-D Zhou ◽  
M-H Zhao
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Case Report ◽  
Plasma Exchange ◽  
Thrombotic Microangiopathy ◽  
Rapid Progression ◽  
Histopathological Diagnosis ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome

Background Microvascular manifestations of antiphospholipid antibody syndrome in the kidneys include acute renal failure, thrombotic microangiopathy and hypertension. Therapy has been largely empiric. Case report A 49-year-old Chinese man presented with anuric acute renal failure without abundant proteinuria and heavy haematuria, but markedly low levels of urinary sodium, potassium and chlorine upon admission. On day 1 of hospitalization, his thrombocytopenia, anaemia and renal failure showed rapid progression. The presence of lupus anticoagulant and vascular ischaemia of the small vessels in renal arteriography were also observed. Anticoagulants, continuous renal replacement therapy, glucocorticoids and six sessions of plasma exchange were started. After the fourth plasma exchange (on day 20), his urine output increased and began to normalize. On day 25, haemodialysis was stopped and his general condition gradually improved. A renal biopsy was subsequently performed, and the histopathological diagnosis was thrombotic microangiopathy due to antiphospholipid antibody syndrome. A further 3-year follow-up showed that his haemoglobin level, platelet count and serum creatinine were within the normal range, with stable blood pressure. Conclusion Treatment modalities such as anticoagulation, immunosuppression and plasma exchange are likely to be necessary when severe acute renal failure combined with thrombotic microangiopathy present in nephropathy of antiphospholipid antibody syndrome.

Downregulation of organic anion transporters OAT1 and OAT3 correlates with impaired secretion of para-aminohippurate after ischemic acute renal failure in rats

2007 ◽  
Vol 292 (5) ◽  
pp. F1599-F1605 ◽  
Author(s):  
R. Schneider ◽  
C. Sauvant ◽  
B. Betz ◽  
M. Otremba ◽  
D. Fischer ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Organic Anion ◽  
Organic Anions ◽  
Organic Anion Transporters ◽  
Protein Levels ◽  
Anion Transporters ◽  
Pah Clearance ◽  
Ischemic Acute Renal Failure

Ischemic acute renal failure (iARF) was described to reduce renal extraction of the organic anion para-aminohippurate (PAH) in humans. The rate-limiting step of renal organic anion secretion is its basolateral uptake into proximal tubular cells. This process is mediated by the organic anion transporters OAT1 and OAT3, which both have a broad spectrum of substrates including a variety of pharmaceutics and toxins. Using a rat model of iARF, we investigated whether impairing the secretion of the organic anion PAH might be associated with downregulation of OAT1 or OAT3. Inulin and PAH clearance was determined starting from 6 up to 336 h after ischemia-reperfusion (I/R) injury. Net secretion of PAH was calculated and OAT1 as well as OAT3 expression was analyzed by RT-PCR and Western blotting. Inulin and PAH clearance along with PAH net secretion were initially diminished after I/R injury with a gradual recovery during follow-up. This initial impairment after iARF was accompanied by decreased mRNA and protein levels of OAT1 and OAT3 in clamped animals compared with sham-operated controls. In correlation to the improvement of kidney function, both mRNA and protein levels of OAT1 and OAT3 were upregulated during the follow-up. Thus decreased expression of OAT1 and OAT3 is sufficient to explain the decline of PAH secretion after iARF. As a result, this may have substantial impact on excretion kinetics and half-life of organic anions. As a consequence, the biological effects of a variety of organic anions may be affected after iARF.

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