1/14. 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) |
2/14. Increasing the dose of furosemide in patients with azotemia and suspected obstruction.diuresis renography is widely used to distinguish obstructed from nonobstructed kidneys; however, the delivery of furosemide to its site of action in the loop of henle is impaired in patients with azotemia. Consequently, the standard adult dose of 40 mg furosemide could be insufficient to generate an adequate diuretic response. This problem is illustrated by a patient with azotemia with bilateral nephrostomies who underwent Tc-99m MAG3 (mercaptoacetyltriglycine) diuresis renography with 40 mg furosemide to determine if his bilateral ureteral obstruction had resolved. The study showed findings typical for obstruction despite the fact that the patient could not have been obstructed because the nephrostomy tubes had not been clamped. When the study was repeated 6 days later with 80 mg furosemide and clamped nephrostomy tubes, there was good drainage bilaterally excluding obstruction. The nephrostomy tubes were removed and the patient's creatinine has subsequently remained stable for 3 years. In summary, this report illustrates the rationale for increasing the dose of furosemide in patients with azotemia referred for diuresis renography and shows how increasing the dose of furosemide could improve the diuretic response and minimize false-positive or indeterminate results.- - - - - - - - - - ranking = 7keywords = azotemia (Clic here for more details about this article) |
3/14. Acute renal failure resulting from huge inguinal bladder hernia.We report a case of a huge inguinal/scrotal bladder hernia presenting as acute renal failure. A 66-year-old man with a large scrotal mass presented with metabolic acidosis and azotemia and was admitted to the intensive care unit. Computed tomography displayed the bladder completely herniated into the scrotum and bilateral hydronephrosis. After stabilization and percutaneous nephrostomy placement, the patient's creatinine markedly improved, and the hernia was repaired. Bilateral ureteral obstruction from a bladder hernia is a very rare event. Computed tomography is rapid and helpful in this situation. hernia repair can safely be performed after nephrostomy drainage.- - - - - - - - - - ranking = 1keywords = azotemia (Clic here for more details about this article) |
4/14. Case report: azotemia secondary to bilateral ureteral kinking from ureteral stents placed at the time of bladder exstrophy closure.We report the case of a neonate who underwent bladder exstrophy repair on the second day of life. Bilateral ureteral stents were placed intra-operatively. Postoperatively azotemia developed secondary to kinking of the proximal ureter bilaterally. Issues in diagnosis and management are discussed.- - - - - - - - - - ranking = 1keywords = azotemia (Clic here for more details about this article) |
5/14. Vicarious excretion of contrast medium in patients without azotemia.Although excretion of urographic iodinated contrast agents via the biliary and gastrointestinal tract is not uncommon in patients with renal insufficiency, such vicarious excretion is unusual in the presence of normal renal function. The observation of such vicarious excretion in 2 patients with acute unilateral ureteral obstruction and no azotemia is reported in conjunction with review of the appropriate literature and suggestion of possible etiologies.- - - - - - - - - - ranking = 5keywords = azotemia (Clic here for more details about this article) |
6/14. Emergency percutaneous nephropyelostomy: experience with 34 patients and review of the literature.Emergency temporary percutaneous nephrophelostomy was performed 35 times in 34 patients. This procedure was used to relieve urinary tract obstruction when azotemia, infection, sepsis, or associated medical conditions precluded surgical correction of a renal obstruction. In all patients there was excellent clinical response. Supine oblique positioning in ill patients facilitates placement of nephrophelostomy tubes.- - - - - - - - - - ranking = 1keywords = azotemia (Clic here for more details about this article) |
7/14. Urethral valves: management of upper urinary tract changes.A conservative approach to upper urinary tract changes in urethral valves is suggested. The bladder is initially decompressed by insertion of a feeding tube via the urethra if the patient has azotemia, acidosis, or serious urinary infection. After correction of fluid and electrolyte deficits and control of infection, the valve is destroyed transurethrally despite the presence of severe upper tract dilatation.- - - - - - - - - - ranking = 1keywords = azotemia (Clic here for more details about this article) |
8/14. retroperitoneal fibrosis: a two decade experience and gynecologic manifestations.A 20-year experience with idiopathic retroperitoneal fibrosis (RPF) is presented (6 cases). Its gynecologic manifestations with the simulation of pelvic malignancy is discussed. Three of the patients presented with pelvic masses, one of these a para-vaginal mass. In one patient, RPF followed or was concurrent with invasive squamous cell carcinoma of the cervix, of which this is the first reported case. The subject of RPF is reviewed with the modes of management and evidence for an autoimmune etiology. thrombocytopenia, a previously unreported finding with RPF, was noted in three of the six patients. The reversal of the A/G ratio in these patients is discussed, correlating this finding with the progression of azotemia.- - - - - - - - - - ranking = 1keywords = azotemia (Clic here for more details about this article) |
9/14. Marked azotemia and increase in serum creatinine: case report of an unusual feature of acute ureteral obstruction in a renal allograft recipient.A patient is described who presented with late ureteral necrosis following renal transplantation, a complication that usually is seen in the early perioperative period. The patient was anuric with azotemia and a high serum creatinine. Response to surgical correction of ureteral obstruction was excellent and renal function returned to normal within 6 days postoperatively.- - - - - - - - - - ranking = 5keywords = azotemia (Clic here for more details about this article) |
10/14. Retroperitoneal neurofibromatosis and venous anomalies.A 45-year-old woman had abdominal pain, azotemia, and hypertension. Intravenous pyelography revealed bilateral ureteral compression by extrinsic tumor masses that proved to be neurofibromata by histologic examination. After surgical removal of the tumors, she became normotensive and asymptomatic. In addition, severe medial hypertrophy of veins was seen in the tissue examined. We believe that the latter is most probably related to the neurofibromatosis and is analogous to the hypertrophic arterial changes known to occur in patients with von Recklinghausen's disease.- - - - - - - - - - ranking = 1keywords = azotemia (Clic here for more details about this article) |
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