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An 18-month-old infant presented with haemolytic uraemic syndrome following a prodrome of colitis. Incomplete recovery of renal function occurred after 4 weeks of anuria and was associated with extensive renal cortical calcification. During the recovery phase he had two relapses of colitis, microangiopathic haemolytic anaemia and thrombocytopenia without any deterioration in renal function.
Tumors of the aorta have been reported infrequently in the literature. We report a case of a 63-year-old woman diagnosed with malignant aortic fibrous histiocytoma (also known as fibroxanthosarcoma). She was referred to us with suspected occlusion of the right renal artery in a single functioning kidney, with a clinical picture of anuria during the previous 48 hours. We also review 31 previously published cases in the literature.
A rare case of multiple bladder stones (more than 300) is described. Acute renal failure and anuria complicated by urosepsis were the presenting symptoms.
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.
OBJECTIVE: The purpose of this study is to emphasize the high risk of renal failure and severe morphologic changes related to prolonged prenatal exposure to indomethacin. STUDY DESIGN: Referred renal specimens from six anuric neonates exposed in utero to indomethacin were studied. Clinical charts were retrospectively reviewed. Indomethacin dosages varied from 150 to 400 mg daily, and the drug was given for a 2- to 11-week period, until birth. RESULTS: All infants died in anuria, 4 of them after 7 to 39 days on peritoneal dialysis. In 5 infants cystic dilatations of superficial nephrons were associated with ischemic changes of the deep cortex. By immunohistochemical analysis intrarenal renin content was increased in 4 of 5 patients. CONCLUSION: Long-term indomethacin treatment during pregnancy may lead to the development of renal failure and irreversible renal damage with cystic dilatation of developing nephrons in an exposed fetus. Prior stimulation of the renin-angiotensin system may favor this complication.
We report a case of anuria in a premature neonate secondary to bilateral ureteropelvic junction obstructions related to Candida bezoars. Percutaneous decompression and drainage of both kidneys contributed significantly to the successful management of renal candidiasis in this patient. A review of the literature is presented.
A fifty-five-year-old man was seen with anuria. Retrograde pyelograms demonstrated bilateral ureteral obstruction subsequently shown to have resulted from sloughed renal papillae. A twenty-year history of phenacetin was obtained. Treatment included bilateral ureteral intubation, then ureterotomy on one side.
The hemolytic uremic syndrome (HUS) must be considered as a cause of oligo-anuria in a previously healthy young child. This syndrome consists of a viral-like prodromal illness, followed by acute renal failure, thrombocytopenia, and an abnormal blood smear with fragmented erythrocytes. Awareness of this syndrome will permit earlier diagnosis and management and will minimize unneccessary investigation in the anuric child.
A case of acute onset of anuria secondary to bilateral ureteropelvic obstruction by fungus balls is presented. Contributing factors, clinical features, and approaches to treatment are discussed.
Unexplained deterioration of renal function after renal transplantation is often an indication for percutaneous needle biopsy of the allograft. This procedure, even when supplemented by modern radiographic techniques, is not without complications. We report a case of anuria secondary to subcapsular hematoma following an ultrasound-guided needle biopsy. Diagnosis, operative management and postoperative care are discussed.
We report a case of restored renal function following 72 days of ureteral obstruction causing anuria, while the patient was maintained with regular hemodialysis. Easy accessibility to hemodialysis might jeopardize the kidney, which could have maintained its function if treated otherwise.
We report on a patient with renal artery stenosis who had only 1 kidney and in whom acute renal impairment developed with transient anuria after the administration of captopril. Although inhibition of the angiotensin-converting enzyme is considered to be efficient treatment for hypertension associated with chronic renal failure, care should be taken when captopril is administered initially to a patient with decreased renal function, under the conditions of sodium and water depletion. The renovascular hypertension in this patient was treated successfully by renal autotransplantation.
A patient with a prior nephrectomy for renovascular hypertension experienced complete anuria secondary to renal artery occlusion. Revascularization 75 hours later resulted in prompt diuresis, recovery of renal function and a 9-year survival. Serial preoperative renal function studies are presented. Deterioration of renal function and recurrent hypertension are believed to have heralded the onset of arterial obstruction to a solitary kidney. The literature concerning the etiology of renal artery occlusion and the rationale for therapy are reviewed.
A patient with bilateral localized amyloidosis of the ureters is described. This is the first case to be reported in which anuria was the presenting symptom, the second case with bilateral involvement and the thirteenth case of amyloidosis localized to the ureter. Careful urologic and hematologic followup is indicated.
Two unusual cases of balloon catheter-induced anuria are presented. Certain pediatric patients and neonates, especially those with spastic neurogenic bladders or those who have had bilateral ureteral reimplantation, are more susceptible to this form of urinary obstruction. The use of non-balloon catheters or infant feeding tubes is recommended.
A 45-year-old woman with a functioning renal transplant for more than 4 years presented with an acute myocardial infarction and anuria. Arteriograms demonstrated an occluded hypogastric artery. Thromboendarterectomy and instillation of fibrinolysin restored renal blood flow. Although death followed recurrent myocardial infarction 1 week postoperatively, urine output was improving and autopsy revealed viable renal tissue.
This case is the first reported presentation of obstructive anuria due to extrinsic ureteral compression in a patient with dermatomyositis. Further evaluation revealed disseminated sigmoid colon adenocarcinoma. Conservative treatment of ureteral obstruction by internal double-J stents achieved appropriate palliation.
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.