1/7. 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 = azotemia (Clic here for more details about this article) |
2/7. Minimally dilated obstructive nephropathy initially suspected as pre-renal azotemia in a kidney donor with volume depletion.Although ultrasonography is regarded as the gold standard in the diagnosis of obstructive nephropathy, dilatation is sometimes not observed by ultrasonography. We report upon a case of minimally dilated obstructive nephropathy due to an ureter stone in a kidney donor with volume depletion. A 54-year-old man was admitted due to anuria and abdominal pain of 2 days duration. Ten years previously, his right kidney was donated for transplantation, and one month before admission, he abstained from all food except water and salt, for 30 days for religious reasons. He had lost 8 kg of body weight. On admission, he had clinical signs of volume depletion, i.e., a dehydrated tongue and decreased skin turgor. Laboratory data confirmed severe renal failure, his blood urea nitrogen level was 107.3 mg/dL, and his serum creatinine 16.5 mg/dL. The plain X-ray was unremarkable and ultrasonography showed only minimal dilatation of the renal collecting system. On follow-up ultrasonography, performed on the 5th hospital day, the dilatation of the collecting system had slightly progressed and a small stone was found at ureter orifice by cystoscopy. Removal of stone initiated dramatic diuresis with a rapid return of renal function to normal by the third day.- - - - - - - - - - ranking = 4keywords = azotemia (Clic here for more details about this article) |
3/7. Urinary ascites: complication of umbilical artery catheterization.In the newborn, intraperitoneal extravasation of urine from a urachal laceration may follow an attempt at umbilical artery catheterization. Clinical results of this injury are neonatal ascites, anuria, and azotemia. Herein, we describe a case of iatrogenic bladder injury with successful management following late detection. The anatomy of the urachus and bladder in the newborn are reviewed as well as clues to the diagnosis of neonatal urinary ascites.- - - - - - - - - - ranking = 1keywords = azotemia (Clic here for more details about this article) |
4/7. Acute oliguric renal failure induced by indomethacin: possible mechanism.A patient with compensated congestive heart failure suffered acute deterioration of her renal function and cardiac status, requiring peritoneal dialysis, in association with indomethacin therapy. Discontinuation of this inhibitor of prostaglandin synthesis led to a prompt improvement in both her renal function and cardiac status. The patient was rechallenged with indomethacin and again developed acute reduction of her glomerular filtration rate and severe volume retention, which were again totally reversed when the drug was stopped. Urinary prostaglandin E was measured by radioimmunoassay in this patient and five additional patients with congestive heart failure and prerenal azotemia. All patients were found to have elevated levels of urinary prostaglandin E. The possible role for renal prostaglandin E as a compensatory mechanism to the vasoconstrictive stimuli present in congestive heart failure is discussed. The potential danger of inhibitors of prostaglandin synthesis in patients with congestive heart failure and prerenal azotemia is emphasized.- - - - - - - - - - ranking = 2keywords = azotemia (Clic here for more details about this article) |
5/7. Lipoid nephrosis appearing as acute oliguric renal failure.Acute oliguric renal failure previously was reported to develop in patients with preexisting idiopathic nephrotic syndrome in association with clinical evidence of vascular volume depletion. We describe an 81-year-old man without recent proteinuria or evidence of preexisting nephrotic syndrome in whom acute oliguric renal failure developed. Renal biopsy disclosed minimal change disease. Nephrotic range proteinuria without severe hypoalbuminemia was detected during the 25-day course of oliguric renal failure. Renal vein thrombosis was excluded. urine sodium concentration and fractional sodium excretion were reduced, yet left ventricular filling pressure was not subnormal and could be increased to supernormal levels without improvement in glomerular filtration rate. oliguria and azotemia were corrected following initiation of glucocorticoid therapy. This case suggests that lipoid nephrosis can appear as acute oliguric renal failure without historical or physical evidence of preexisting nephrotic syndrome.- - - - - - - - - - ranking = 1keywords = azotemia (Clic here for more details about this article) |
6/7. Idiopathic rupture of bladder.Idiopathic bladder rupture is uncommon but not rare. It should be considered in patients with depressed sensorium who present with mild azotemia, acidosis, and inability to void. A cystogram is diagnostic, and recovery is usually uneventful after primary bladder closure.- - - - - - - - - - ranking = 1keywords = azotemia (Clic here for more details about this article) |
7/7. A case of reflex anuria and uremia related to a unilateral ureteral stone.A 63-year-old man had anuria associated with a unilateral ureteral stone for 24 hours. Laboratory data indicated marked azotemia with the serum creatinine concentration of 7.2 mg/dL and urea nitrogen of 48 mg/dL. The radiological findings revealed contralateral hydronephrosis. Spontaneous discharge of the ureteral stone reversed the anuria and uremia. Both ureteral and vascular spasms were attributed to the anuria in this patient.- - - - - - - - - - ranking = 1keywords = azotemia (Clic here for more details about this article) |