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Fink BA, Son Y, Clearie R, Kim B, Mueller TJ. Spontaneous Rupture of the Renal Pelvis Due to Extrinsic Obstruction by Metastatic Retroperitoneal Lymphadenopathy. Cureus 2022; 14:e22986. [PMID: 35415055 PMCID: PMC8994016 DOI: 10.7759/cureus.22986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2022] [Indexed: 11/05/2022] Open
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Tylski M, Muras-Szwedziak K, Nowicki M. Idiopathic Spontaneous Rupture of Renal Pelvis in a Single Functioning Kidney. Case Rep Nephrol Dial 2021; 11:221-226. [PMID: 34414214 PMCID: PMC8339495 DOI: 10.1159/000512588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 10/25/2020] [Indexed: 11/26/2022] Open
Abstract
Spontaneous rupture of renal pelvis (SRRP) is a rare condition resulting in an extravasation of urine into retroperitoneal space. Due to the uncharacteristic symptoms, often mimicking renal colic, its diagnosis may be complicated. Herein, we report a case of a 73-year-old male with a solitary functioning kidney who presented with malaise and right-sided abdominal pain, rapidly followed by anuria. Laboratory tests showed the signs of AKI. Contrast-enhanced CT performed soon after the admission showed nonspecific abnormalities in the right middle abdomen suspected to be either inflammatory infiltration or surgical scarring. Symptomatic treatment was started, and an acute hemodialysis treatment was commenced. After a temporal improvement, the patient's general condition worsened significantly, with exacerbated pain and massive increase in plasma creatinine. A second contrast-enhanced CT was performed with an addition of urography phase, revealing the extravasation of the contrast media in the location suggesting the rupture of the renal pelvis. The patient was treated successfully by the placement of a double-J ureteral stent into the ureter. Usually, a clear etiology of SRRP can be determined, that is, urinary tract obstruction, but in this case, we could not find a definite cause. It is important to remember that in the presence of a nonspecific abdominal pain and laboratory signs of AKI, a rare cause like SRRP should be taken into consideration. Performing a contrast CT scan with urography phase can save time in establishing a diagnosis and enable immediate urological intervention.
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Affiliation(s)
- Maciej Tylski
- Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, Poland
| | - Katarzyna Muras-Szwedziak
- Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, Poland
| | - Michał Nowicki
- Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, Poland
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Viyannan M, Kappumughath Mohamed S, Nagappan E, Balalakshmoji D. Doppler sonographic evaluation of resistive index of intra-renal arteries in acute ureteric obstruction. J Ultrasound 2020; 24:481-488. [PMID: 33210264 DOI: 10.1007/s40477-020-00539-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/30/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Acute ureteric colic is one of the most commonly encountered acute abdominal conditions. Diagnosis of obstruction caused by ureteric calculus occasionally becomes challenging if there is inadequate dilation of the urinary tract proximal to obstruction. In such a situation, intra-renal artery Doppler parameters can be used as a diagnostic tool. Our study compared intra-renal arterial Doppler in patients with obstructed and non-obstructed kidneys presenting within 24 h of onset of symptoms of unilateral acute renal colic. RESULTS The resistivity index (RI) in the segmental arteries of all 54 patients with obstructed kidneys was significantly higher than in those with non-obstructed kidney: 0.75 vs. 0.56, with a p value less than 0.001, a sensitivity of 85% and a specificity of 93%. CONCLUSION Doppler ultrasound is a useful diagnostic tool in the evaluation of acute renal obstruction, thus enabling practitioners to avoid ordering unnecessary CT and exposing patients to ionizing radiation. An RI value > 0.7 has good sensitivity and specificity in our study. The results obtained in the study were comparable to those of pioneer studies conducted worldwide.
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Affiliation(s)
- Maheswaran Viyannan
- Department of Radiology, No.3 Aaradhana, Gandhi Nagar, Masakalipalayam, Uppilipalayam, Coimbatore, 641015, Tamilnadu, India.
| | - Shamsa Kappumughath Mohamed
- Department of Radiology, No.3 Aaradhana, Gandhi Nagar, Masakalipalayam, Uppilipalayam, Coimbatore, 641015, Tamilnadu, India
| | - Elango Nagappan
- Department of Radiology, No.3 Aaradhana, Gandhi Nagar, Masakalipalayam, Uppilipalayam, Coimbatore, 641015, Tamilnadu, India
| | - Devanand Balalakshmoji
- Department of Radiology, PSG Institute of Medical Sciences and Research, Peelamedu, Coimbatore, India
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Wang Y, Zhang H, Yang Z, Miao D, Zhang D. Rho Kinase Inhibitor, Fasudil, Attenuates Contrast‐induced Acute Kidney Injury. Basic Clin Pharmacol Toxicol 2017; 122:278-287. [PMID: 28929640 DOI: 10.1111/bcpt.12895] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 08/21/2017] [Indexed: 01/10/2023]
Affiliation(s)
- Yiming Wang
- Department of Cardiology First Affiliated Hospital of Nanjing Medical University Nanjing China
- Department of Cardiology Zhenjiang First People's Hospital Zhenjiang China
| | - Hao Zhang
- Department of Cardiology First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Zhijian Yang
- Department of Cardiology First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Dengshun Miao
- Research Center for Bone and Stem Cells Nanjing Medical University Nanjing China
| | - Dingguo Zhang
- Department of Cardiology First Affiliated Hospital of Nanjing Medical University Nanjing China
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Kim HY, Choe HS, Lee DS, Yoo JM, Lee SJ. Transient renal impairment in the absence of pre-existing chronic kidney disease in patients with unilateral ureteric stone impaction. Urolithiasis 2016; 45:249-254. [PMID: 27388450 DOI: 10.1007/s00240-016-0904-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 07/02/2016] [Indexed: 11/28/2022]
Abstract
This study aims to describe the rate and characteristics of transient renal impairment in unilateral ureteric stone patients without chronic kidney disease (CKD) and to identify factors that may have influenced renal function of these patients. Unilateral ureteric stone patients who visited our hospital's emergency department from December, 2009 to December, 2015 were divided into two groups based on estimated glomerular filtration rate (eGFR): group I (patients with eGFR ≥ 60 ml/min/1.73 m2) and group II (eGFR < 60 ml/min/1.73 m2). A univariate comparison between groups I and II was performed. Multivariable logistic regression analysis was performed to determine factors that influenced renal function. There were 107 patients in group II, which constituted 5.6 % of the total patients. In the multivariable logistic regression analysis, age (p < 0.001, odds ratio [OR] = 1.069, confidence interval [CI] = 1.049-1.089), hypertension (p < 0.001, OR = 2.302, CI = 1.467-3.611), stone size (p = 0.001, OR = 1.141, CI = 1.057-1.231), white blood cell count (p = 0.001, OR = 1.132, CI = 1.055-1.215) and hematuria (p < 0.001, OR = 0.383, CI = 0.231-0.636) were found to be independent factors for renal impairment. Based on the results of this study, the rate of renal impairment was 6 % of the unilateral ureteric stone patients without pre-existing CKD. Age and hypertension were found to be independent factors for renal impairment; NSAIDs should be used cautiously or other agents for pain relief such as opioids should be considered in old aged patients with hypertension.
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Affiliation(s)
- Hee Youn Kim
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon-si, Gyeonggi-do, 16247, Republic of Korea
| | - Hyun-Sop Choe
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon-si, Gyeonggi-do, 16247, Republic of Korea
| | - Dong Sup Lee
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon-si, Gyeonggi-do, 16247, Republic of Korea
| | - Jae Mo Yoo
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon-si, Gyeonggi-do, 16247, Republic of Korea
| | - Seung-Ju Lee
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon-si, Gyeonggi-do, 16247, Republic of Korea.
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