1/127. Unilateral renal agenesis presenting as anuria.The most common cause of sudden and total cessation of urine output is obstructive uropathy, usually at the bladder outlet. Bilateral ureteral obstruction is a much less common cause of anuria. In additioh, unilateral obstruction in the presence of a solitary kidney must be considered in the differential diagnosis. Primary renal parenchymal disorders and pre-renal azotemia occasionally may be anuric but more commonly are oliguric. A case of unilateral renal agenesis presenting as anuria and obstruction of the solitary kidney is described.- - - - - - - - - - ranking = 1keywords = anuria (Clic here for more details about this article) |
2/127. Renal aspergillosis giving rise to obstructive uropathy and recurrent anuric renal failure.A sixty-year-old previously healthy male patient presented with anuric renal failure of sudden onset. He was detected to have aspergillus fumigatus fungal balls in the renal pelvis, ureters and bladder which were removed and his renal function improved. He was treated with itraconazole and sent home. Three weeks later he again presented with anuria and renal failure. He had recurrence of the obstruction with the same fungus. The fungal ball was removed, a double 'J' stenting was performed and he was treated with amphotericin b and itraconazole. Hence we report a previously healthy patient with no evidence of immunosuppression presenting an obstructive anuric renal failure due to isolated renal aspergillosis.- - - - - - - - - - ranking = 0.16666666666667keywords = anuria (Clic here for more details about this article) |
3/127. Stenturia: An unusual manifestation of spontaneous ureteral stent fragmentation.Two patients presented with passage of worm-like stent fragments in the urine. The first had undergone attempted percutaneous removal of left renal calculus and ureteral stenting 4 months prior to presentation. The second had left-sided stent placement for obstructive anuria on account of bilateral renal calculi 3 months earlier. The stents had fragmented into multiple pieces over a mean indwelling time of only 3.5 months. Apart from calculus disease, both patients had documented urinary tract infection. Stent fragmentation is a relatively rare (0.3%) but major complication. However, spontaneous excretion of these fragments has not been hitherto reported. These cases of rapid stent disintegration highlight the need for closer monitoring of the indwelling stents, especially in patients with calculus disease and associated persistent infection. In such patients the stent should probably be changed within 3 months.- - - - - - - - - - ranking = 0.16666666666667keywords = anuria (Clic here for more details about this article) |
4/127. Iliac arteriovenous fistula secondary to iliac aneurysm rupture associated with pulmonary embolism and anuria.We present a case of iliac aneurysm rupture that started with high-output cardiac failure and anuria and later presented as a pulmonary embolism that needed a preoperatory filter for the cava vein.- - - - - - - - - - ranking = 0.83333333333333keywords = anuria (Clic here for more details about this article) |
5/127. Bilateral percutaneous nephrolithotomy for multiple cystine stones in an infant presenting with anuria.We report the first case of simultaneous, bilateral percutaneous management of multiple urinary cystine stones in a 7.6-kg, 9-month-old infant who presented with anuria. A stone-free state was successfully achieved.- - - - - - - - - - ranking = 0.83333333333333keywords = anuria (Clic here for more details about this article) |
6/127. Repeated transient anuria following losartan administration in a patient with a solitary kidney.We report the case of a 70-year-old hypertensive man with a solitary kidney and chronic renal insufficiency who developed two episodes of transient anuria after losartan administration. He was hospitalized for a myocardial infarction with pulmonary edema, treated with high-dose diuretics. Due to severe systolic dysfunction losartan was prescribed. Surprisingly, the first dose of 50 mg of losartan resulted in a sudden anuria, which lasted eight hours despite high-dose furosemide and amine infusion. One week later, by mistake, losartan was prescribed again and after the second dose of 50 mg, the patient developed a second episode of transient anuria lasting 10 hours. During these two episodes, his blood pressure diminished but no severe hypotension was noted. Ultimately, an arteriography showed a 70-80% renal artery stenosis. In this patient, renal artery stenosis combined with heart failure and diuretic therapy certainly resulted in a strong activation of the renin-angiotensin system (RAS). Under such conditions, angiotensin ii receptor blockade by losartan probably induced a critical fall in glomerular filtration pressure. This case report highlights the fact that the angiotensin ii receptor antagonist losartan can cause serious unexpected complications in patients with renovascular disease and should be used with extreme caution in this setting.- - - - - - - - - - ranking = 1.1666666666667keywords = anuria (Clic here for more details about this article) |
7/127. Giant nonpancreatic pseudocyst causing acute anuria.Giant intraabdominal cysts masquerading as ascites are not uncommon. We present a unique case of a giant intraabdominal pseudocyst that resulted in acute abdominal compartment syndrome, leading to anuria and acute renal failure. A 52-year-old woman with known severe cardiac dysfunction presented with generalized edema, marked abdominal distension, and decreased urine output. She was initially presumed to have congestive heart failure with refractory ascites. She became completely anuric. A diagnosis of intraabdominal compartment syndrome from a giant cyst was ultimately made after careful review of her abdominal imaging. Urgent drainage and subsequent marsupialization of the giant pseudocyst resulted in immediate diuresis and a subsequent return to her baseline renal function. As this case illustrates, differentiation of pseudoascites from true ascites may be difficult in a clinical setting or using laboratory studies. A clear differentiation can usually be made using imaging studies, mainly magnetic resonance imaging, computerized axial tomography, or ultrasound. To our knowledge, this is the first case report of a nonrenal pseudocyst or cyst leading to acute renal failure from extrinsic compression. Abdominal compartment syndrome needs to be considered in the differential diagnosis of patients with acute renal failure and presumed large-volume ascites.- - - - - - - - - - ranking = 0.83333333333333keywords = anuria (Clic here for more details about this article) |
8/127. reflex anuria from unilateral ureteral obstruction.Renal function is usually normal or only marginally affected in patients with unilateral ureteral obstruction due to the vicarious function of the contralateral kidney. Few reports exist in which unilateral renal obstruction is associated with anuria (reflex anuria, RA) and acute renal failure. We report the clinical case of a female patient who was referred to the emergency department due to anuria of 72 h duration and acute renal failure (serum creatinine 9 mg/dl) associated with several episodes of violent right flank pain with hematuria following extracorporeal shock wave lithotripsy (ESWL). A few weeks before ESWL, urography showed a 2-cm stone located in the right pelvis whilst the left kidney was functionally normal. On admission, renal ultrasound documented a normal left kidney, whilst the right pelvis was hydronephrotic and there were two indwelling stones at the right pyeloureteral junction. After the patient passed a urinary stone, diuresis restarted and acute renal failure was resolved. Thereafter, urography confirmed that the left kidney, the left ureter and bladder were functionally and morphologically normal. RA with acute renal failure has been so scarcely documented that it is considered to be legend by many clinicians. Major textbooks do not discuss RA with acute renal failure. Vascular or ureteral spasm related in part to a peculiar hyperexcitability of the autonomic nervous system may explain RA. We suggest that nephrologists should always consider RA when evaluating acute renal failure. On the other hand, RA might be relatively common and we cannot rule out that only the most severe and/or better-documented cases have been reported in the medical literature.- - - - - - - - - - ranking = 1.1666666666667keywords = anuria (Clic here for more details about this article) |
9/127. digoxin poisoning and anuric acute renal failure: efficiency of the treatment associating digoxin-specific antibodies (Fab) and plasma exchanges.digoxin-specific antibodies (Fab) are currently the treatment of choice for digoxin intoxication. These fragments bind to digoxin, leading to Fab-digoxin complexes, and promote the release of receptor-bound digoxin. These complexes are renally excreted. In the case of anuria, they could be dissociated and lead to renewed intoxication. In this case plasma exchanges are proposed. We report the case of an anuric patient with digoxin intoxication, treated with a Fab injection, followed by a plasma exchange 16 hours later, a second Fab injection was given followed by two plasma exchanges, 38 and 86 hours later. The disappearance of cardiac abnormalities showed the efficiency of the Fab, the drop in serum digoxin concentration and the high digoxin concentration in the exchanged plasma indicate effective elimination. The association of Fab and plasma exchanges could be proposed in the case of digoxin intoxication in the anuric patient.- - - - - - - - - - ranking = 0.16666666666667keywords = anuria (Clic here for more details about this article) |
10/127. Acute renal failure caused by leptospirosis.Three patients with severe leptospirosis leading to anuria and treated with haemodialysis are reported. One patient died. The pathomechanism and the underlying pathological and histological changes of the renal failure are discussed. It is stressed that the clinical diagnosis of leptospirosis is often difficult, as other infectious diseases,first of all infectious hepatitis, frequently present the same symptoms.- - - - - - - - - - ranking = 0.16666666666667keywords = anuria (Clic here for more details about this article) |
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