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Beji S, Hajji M, Rais L, Kheder R, Jebali H, Smaoui W, Krid M, Ben Hamida F, Ben Fatma L, Zouaghi MK. Acute renal cortical necrosis in pregnancy: Clinical course and changing prognosis. Nephrol Ther 2018; 13:550-552. [PMID: 29100716 DOI: 10.1016/j.nephro.2016.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 08/22/2016] [Accepted: 10/17/2016] [Indexed: 12/01/2022]
Abstract
Obstetric cortical renal necrosis is a serious complication that can lead to chronic renal failure and the need for chronic dialysis. The aim of renal cortical necrosis therapy is to restore hemodynamic stability, institute early dialytic therapy, and treat the underlying cause of the disease. Most cases of renal cortical necrosis do not recover a normal renal function despite intensive care. We describe the course of a patient who was diagnosed with acute renal cortical necrosis in pregnancy treated with hemodialysis for three years but then she recovered her renal function.
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Affiliation(s)
- Soumaya Beji
- Nephrology Department, La Rabta Hospital, Tunis, Tunisia; Laboratory of Kidney disease LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia
| | - Meriam Hajji
- Nephrology Department, La Rabta Hospital, Tunis, Tunisia; Laboratory of Kidney disease LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia.
| | - Lamia Rais
- Nephrology Department, La Rabta Hospital, Tunis, Tunisia; Laboratory of Kidney disease LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia
| | - Rania Kheder
- Nephrology Department, La Rabta Hospital, Tunis, Tunisia; Laboratory of Kidney disease LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia
| | - Hela Jebali
- Nephrology Department, La Rabta Hospital, Tunis, Tunisia; Laboratory of Kidney disease LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia
| | - Wided Smaoui
- Nephrology Department, La Rabta Hospital, Tunis, Tunisia; Laboratory of Kidney disease LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia
| | - Madiha Krid
- Nephrology Department, La Rabta Hospital, Tunis, Tunisia; Laboratory of Kidney disease LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia
| | - F Ben Hamida
- Nephrology Department, La Rabta Hospital, Tunis, Tunisia; Laboratory of Kidney disease LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia
| | - Lilia Ben Fatma
- Nephrology Department, La Rabta Hospital, Tunis, Tunisia; Laboratory of Kidney disease LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mohammed Karim Zouaghi
- Nephrology Department, La Rabta Hospital, Tunis, Tunisia; Laboratory of Kidney disease LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia
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Bloom R, Swenson RS, Coplon NS. Acute renal cortical necrosis. Variable course and changing prognosis. Calif Med 1973; 119:1-5. [PMID: 4749308 PMCID: PMC1455251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Three cases of acute bilateral renal cortical necrosis, each with a different clinical course, are discussed. One patient spontaneously recovered renal function after prolonged oliguria. This case should be added to the small number of similar case reports in the literature. The second patient recovered adequate renal function temporarily, but eventually required chronic hemodialysis and renal transplantation. There was pathological evidence of progression from focal to massive cortical necrosis. The third patient never regained renal function, but is well after dialysis and transplantation. The influence of modern theories of pathogenesis of the disease, and increased availability of dialysis, are discussed in relation to the initial prognostic assessment of the patient with cortical necrosis.
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