M. Omar, S. Tarplin, Alla El Deen El Mahdy, M. Monga
Background: The aim of the study was to evaluate the correlation between 24-hour urine supersaturation (SS) levels and the crystalline stone composition. Methods: We retrospectively reviewed the results of stone analysis of 386 patients who had completed 24-hour urine stone risk profiles within 2 months of stone analysis. Patients were characterized as calcium oxalate (CAOX), calcium phosphate (CAPH) or uric acid (UA) stone formers based on the predominant component (> 60%) of their stone. Patients with < 50% of one stone composition were characterized as a mixed stone former. Sensitivity, specificity and accuracy of the 24-hour urine SS for predicting the corresponding stone component were calculated. Results: The distribution of stone compositions was 235 (61%) CAOX, 98 (25%) CAPH, 35 (9%) UA and 18 (5%) mixed stone group. At predominant stone mineral concentration ? 60%, the accuracy of 24-hour urine SS for predicting the predominant stone composition was 52.5% for CAOX, 70% for CAPH and 67% for UA group. Even when the predominant stone mineral concentration was ? 90%, the accuracy of SS did not improve: COAX (49%, P = 0.6641), CAPH (77%, P = 0.361) and UA (67%, P = 0.9593). Conclusions: Twenty-four-hour urine SS has a poor accuracy to predict the predominant stone composition. Accuracy is highest for patients with CAPH stones. World J Nephrol Urol. 2015;4(1):169-172 doi: http://dx.doi.org/10.14740/wjnu206w
背景:本研究的目的是评估24小时尿过饱和度(SS)水平与结晶石组成之间的关系。方法:我们回顾性分析了386例患者的结石分析结果，这些患者在2个月内完成了24小时尿结石风险分析。根据结石的主要成分(bbb60 %)，将患者分为草酸钙(CAOX)、磷酸钙(CAPH)或尿酸(UA)结石患者。一种结石成分< 50%的患者被认为是混合结石。计算24小时尿液SS预测相应结石成分的敏感性、特异性和准确性。结果:结石组成分布为CAOX组235例(61%)，CAPH组98例(25%)，UA组35例(9%)，混合石组18例(5%)。在主要的石矿物浓度?24小时尿液SS预测CAOX组主要结石组成的准确率为52.5%，CAPH组为70%，UA组为67%。即使当主要的石质矿物浓度是?COAX (49%， P = 0.6641)、CAPH (77%， P = 0.361)和UA (67%， P = 0.9593)的准确率均未提高。结论:24小时尿液SS预测主要结石组成的准确性较差。对于有CAPH结石的患者，准确率最高。世界植物学报，2015;4(1):169-172 doi: http://dx.doi.org/10.14740/wjnu206w
{"title":"Does 24-Hour Urine Supersaturation Predict Stone Composition?","authors":"M. Omar, S. Tarplin, Alla El Deen El Mahdy, M. Monga","doi":"10.14740/WJNU206W","DOIUrl":"https://doi.org/10.14740/WJNU206W","url":null,"abstract":"Background: The aim of the study was to evaluate the correlation between 24-hour urine supersaturation (SS) levels and the crystalline stone composition. Methods: We retrospectively reviewed the results of stone analysis of 386 patients who had completed 24-hour urine stone risk profiles within 2 months of stone analysis. Patients were characterized as calcium oxalate (CAOX), calcium phosphate (CAPH) or uric acid (UA) stone formers based on the predominant component (> 60%) of their stone. Patients with < 50% of one stone composition were characterized as a mixed stone former. Sensitivity, specificity and accuracy of the 24-hour urine SS for predicting the corresponding stone component were calculated. Results: The distribution of stone compositions was 235 (61%) CAOX, 98 (25%) CAPH, 35 (9%) UA and 18 (5%) mixed stone group. At predominant stone mineral concentration ? 60%, the accuracy of 24-hour urine SS for predicting the predominant stone composition was 52.5% for CAOX, 70% for CAPH and 67% for UA group. Even when the predominant stone mineral concentration was ? 90%, the accuracy of SS did not improve: COAX (49%, P = 0.6641), CAPH (77%, P = 0.361) and UA (67%, P = 0.9593). Conclusions: Twenty-four-hour urine SS has a poor accuracy to predict the predominant stone composition. Accuracy is highest for patients with CAPH stones. World J Nephrol Urol. 2015;4(1):169-172 doi: http://dx.doi.org/10.14740/wjnu206w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 1","pages":"169-172"},"PeriodicalIF":0.0,"publicationDate":"2015-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: At present, the possible effect of arginine as a natural regulator of calcium oxalate (CaOX) supersaturation and crystallization in human urine has been analyzed. Methods: Two types of experiments have been discussed: clinical laboratory analysis on the urine excretion of arginine (Arg) in patients with CaOX lithiasis and detailed measurements of the kinetics of the dissolution of CaOX calculi in artificial urine, containing various concentrations of Arg. Results: A detailed analysis showed that 80% of stone formers (SFs) eliminated pathological values: 30% of patients had lower plasma levels compared to controls and about 50% of SFs showed higher concentration. Urine concentrations in these two groups were not reported. Conclusions: The in vitro analytical measurements demonstrate even a possibility to dissolve CaOX stones in human urine, in which increased concentration of Arg has been established. Discussions have arisen to use increased concentration of Arg in urine both as a solubilizator of CaOX stones in humans and on the purpose of a prolonged metaphylactic treatment. World J Nephrol Urol. 2015;4(1):173-177 doi: http://dx.doi.org/10.14740/wjnu199w
{"title":"Arginine as a Significant Regulator of Supersaturation in Calcium Oxalate Lithiasis: the Physiological Evidence","authors":"S. Atanassova","doi":"10.14740/WJNU199W","DOIUrl":"https://doi.org/10.14740/WJNU199W","url":null,"abstract":"Background: At present, the possible effect of arginine as a natural regulator of calcium oxalate (CaOX) supersaturation and crystallization in human urine has been analyzed. Methods: Two types of experiments have been discussed: clinical laboratory analysis on the urine excretion of arginine (Arg) in patients with CaOX lithiasis and detailed measurements of the kinetics of the dissolution of CaOX calculi in artificial urine, containing various concentrations of Arg. Results: A detailed analysis showed that 80% of stone formers (SFs) eliminated pathological values: 30% of patients had lower plasma levels compared to controls and about 50% of SFs showed higher concentration. Urine concentrations in these two groups were not reported. Conclusions: The in vitro analytical measurements demonstrate even a possibility to dissolve CaOX stones in human urine, in which increased concentration of Arg has been established. Discussions have arisen to use increased concentration of Arg in urine both as a solubilizator of CaOX stones in humans and on the purpose of a prolonged metaphylactic treatment. World J Nephrol Urol. 2015;4(1):173-177 doi: http://dx.doi.org/10.14740/wjnu199w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 1","pages":"173-177"},"PeriodicalIF":0.0,"publicationDate":"2015-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Sabale, V. Satav, B. Kadyan, S. Kankalia, D. Mane, A. Mulay
A ureter that opens at a site distal to the posterolateral aspect of the trigone is known as ectopic ureter. Commonly with complete duplication, upper moiety ureter can be ectopic. A 7-year-old boy presented with dull pain in right flank with repeated episodes of urinary tract infection. Clinically, no abnormality was detected. Ultrasonography revealed right gross hydronephrosis with hydroureter up to ureterovesical junction. Micturating cystourethrogram suggested grade V reflux in both ureters of complete duplication. Right kidney had 20% split function (glomerular filtration rate: 18 mL/minute). Cystoscopy revealed both the ureteric orifice in small prostatic urethral diverticulum. Common sheath ureteric reimplantation was done by Politano-Leadbetter technique. Ectopic ureteral orifice is not uncommon, especially with complete duplication. But complete duplication opening in ectopic position (prostatic urethra) with high grade reflux in both the ureters is extremely uncommon entity. No similar case report could be seen in available literature, making this a unique case. World J Nephrol Urol. 2015;4(1):181-182 doi: http://dx.doi.org/10.14740/wjnu195w
{"title":"Unilateral Complete Duplication of Ectopic, Refluxing Ureters: A Rarest Entity","authors":"V. Sabale, V. Satav, B. Kadyan, S. Kankalia, D. Mane, A. Mulay","doi":"10.14740/WJNU195W","DOIUrl":"https://doi.org/10.14740/WJNU195W","url":null,"abstract":"A ureter that opens at a site distal to the posterolateral aspect of the trigone is known as ectopic ureter. Commonly with complete duplication, upper moiety ureter can be ectopic. A 7-year-old boy presented with dull pain in right flank with repeated episodes of urinary tract infection. Clinically, no abnormality was detected. Ultrasonography revealed right gross hydronephrosis with hydroureter up to ureterovesical junction. Micturating cystourethrogram suggested grade V reflux in both ureters of complete duplication. Right kidney had 20% split function (glomerular filtration rate: 18 mL/minute). Cystoscopy revealed both the ureteric orifice in small prostatic urethral diverticulum. Common sheath ureteric reimplantation was done by Politano-Leadbetter technique. Ectopic ureteral orifice is not uncommon, especially with complete duplication. But complete duplication opening in ectopic position (prostatic urethra) with high grade reflux in both the ureters is extremely uncommon entity. No similar case report could be seen in available literature, making this a unique case. World J Nephrol Urol. 2015;4(1):181-182 doi: http://dx.doi.org/10.14740/wjnu195w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 1","pages":"181-182"},"PeriodicalIF":0.0,"publicationDate":"2015-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rosielly Melo Tavares, Yasmin Silva e Sousa, Ginivaldo Victor Ribeiro do Nascimento
Cross-fused renal ectopia is a rarely described congenital kidney anomaly. It can occur in association with ureteropelvic obstruction, vesicoureteral reflux, and multicystic dysplasia, which sometimes leads to nephrolithiasis and recurrent urinary infection. However, complications related to glomerulopathies are rare in patients with congenital kidney anomaly. Here, we report a case of cross-fused renal ectopia associated with focal segmental glomerulosclerosis (FSGS). The initial clinical findings suggested the possibility of secondary FSGS; nonetheless immunosuppression was successfully done. The case demonstrates a never-before reported association in an asymptomatic patient. World J Nephrol Urol. 2015;4(1):183-185 doi: http://dx.doi.org/10.14740/wjnu207w
{"title":"Association Between Focal Segmental Glomerulosclerosis and Cross-Fused Renalectopia: A New Cause of Secondary Focal Segmental Glomerulosclerosis or a Casual Association?","authors":"Rosielly Melo Tavares, Yasmin Silva e Sousa, Ginivaldo Victor Ribeiro do Nascimento","doi":"10.14740/WJNU207W","DOIUrl":"https://doi.org/10.14740/WJNU207W","url":null,"abstract":"Cross-fused renal ectopia is a rarely described congenital kidney anomaly. It can occur in association with ureteropelvic obstruction, vesicoureteral reflux, and multicystic dysplasia, which sometimes leads to nephrolithiasis and recurrent urinary infection. However, complications related to glomerulopathies are rare in patients with congenital kidney anomaly. Here, we report a case of cross-fused renal ectopia associated with focal segmental glomerulosclerosis (FSGS). The initial clinical findings suggested the possibility of secondary FSGS; nonetheless immunosuppression was successfully done. The case demonstrates a never-before reported association in an asymptomatic patient. World J Nephrol Urol. 2015;4(1):183-185 doi: http://dx.doi.org/10.14740/wjnu207w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 1","pages":"183-185"},"PeriodicalIF":0.0,"publicationDate":"2015-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67238560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report a case of a 64-year-old male with prostate cancer and coagulation disorder who presented with abdominal distension. He underwent abdomen and pelvis ultrasound for assessment of ascites, which showed localized fluid collections identified at the left and right iliac fossa. After that, non - enhanced abdomen and pelvis CT scan was performed and showed heterogeneous organized collections identified along the psoas muscles bilaterally, causing focal contour bulge representing hematoma. World J Nephrol Urol. 2014;3(3):137-139 doi: http://dx.doi.org/10.14740/wjnu179e
{"title":"Hematoma of the Psoas Muscle in Prostatic Cancer Patient: A Case Report","authors":"Z. Almushayti, Abduljaleel Poovathumkadavi","doi":"10.14740/WJNU179E","DOIUrl":"https://doi.org/10.14740/WJNU179E","url":null,"abstract":"We report a case of a 64-year-old male with prostate cancer and coagulation disorder who presented with abdominal distension. He underwent abdomen and pelvis ultrasound for assessment of ascites, which showed localized fluid collections identified at the left and right iliac fossa. After that, non - enhanced abdomen and pelvis CT scan was performed and showed heterogeneous organized collections identified along the psoas muscles bilaterally, causing focal contour bulge representing hematoma. World J Nephrol Urol. 2014;3(3):137-139 doi: http://dx.doi.org/10.14740/wjnu179e","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"3 1","pages":"137-139"},"PeriodicalIF":0.0,"publicationDate":"2014-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joseph Chan, Anil Bajnath, Beth Fromkin, D. Haine, R. Paixao, D. Sandy, Umair Rhandhawa, Fei Wang, M. Braun
Background: Ketorolac has been documented to cause acute kidney injury (AKI) but current data suggest that it is safe for those who have low risk for renal dysfunction. In our facility, there have been cases of AKI in those treated with K etorolac but the incidence is not known. This study describes the prescribing habits of K etorolac in our facility and determines the incidence of AKI while on this therapy. Methods: Electronic medical records of patients who received K etorolac were reviewed during the last 3 months of 2012. AKI was defined as an increase of serum creatinine of 0.3 mg/dL or greater and a decrease in estimated glomerular filtration rate (eGFR) to less than 60 mL/min ute . Results: A total of 633 patient charts were reviewed and 341 patients met the inclusion criteria. The mean age was 45.7 years. Sixty-five percent of the patients were females and 35% were males. The most common diagnosis for prescribing Ketorolac was osteoarthrosis. Thirty milligram IV every 6 hours is the conventional prescribed dose. Of the patients 6.4% developed AKI during treatment with Ketorolac, 68% of those with AKI were 65 or older, 68% had hypertension, 41% were diabetic, 40% were concomitantly receiving either an angiotensin converting enzyme-inhibitor (ACE-I) or an angiotensin receptor blocker ( ARB), 40% were also being given diuretics, 72% received Ketorolac during the time of AKI and 3.8% of all patients who received Ketorolac developed hyperkalemia while on treatment. Conclusions: AKI occurs more commonly than previously anticipated in Ketorolac treated patients even at average doses and short durations. Hypertension and diabetes are the two most common comorbidities in patients who developed AKI. Those who are greater than 65 years old may be at higher risk. Concomitant use of drugs that affect renal function, such as ACE-I, ARBs and diuretics, may increase the risk of AKI. Ketorolac prescribing in the acute care hospital should consider individual comorbidities, and use of other drugs that can increase kidney failure risk. Awareness of current renal function through diligent review of daily labs may help prevent administration of Ketorolac in those with impaired renal function. Medication alerts that notifying the ordering physician of the eGFR may help prevent inadvertent prescription in those with AKI or chronic kidney disease . World J Nephrol Urol. 2014;3(3):113-117 doi: http://dx.doi.org/10.14740/wjnu169w
{"title":"Ketorolac Prescribing Practices in an Acute Care Hospital and the Incidence of Acute Renal Failure","authors":"Joseph Chan, Anil Bajnath, Beth Fromkin, D. Haine, R. Paixao, D. Sandy, Umair Rhandhawa, Fei Wang, M. Braun","doi":"10.14740/WJNU169W","DOIUrl":"https://doi.org/10.14740/WJNU169W","url":null,"abstract":"Background: Ketorolac has been documented to cause acute kidney injury (AKI) but current data suggest that it is safe for those who have low risk for renal dysfunction. In our facility, there have been cases of AKI in those treated with K etorolac but the incidence is not known. This study describes the prescribing habits of K etorolac in our facility and determines the incidence of AKI while on this therapy. Methods: Electronic medical records of patients who received K etorolac were reviewed during the last 3 months of 2012. AKI was defined as an increase of serum creatinine of 0.3 mg/dL or greater and a decrease in estimated glomerular filtration rate (eGFR) to less than 60 mL/min ute . Results: A total of 633 patient charts were reviewed and 341 patients met the inclusion criteria. The mean age was 45.7 years. Sixty-five percent of the patients were females and 35% were males. The most common diagnosis for prescribing Ketorolac was osteoarthrosis. Thirty milligram IV every 6 hours is the conventional prescribed dose. Of the patients 6.4% developed AKI during treatment with Ketorolac, 68% of those with AKI were 65 or older, 68% had hypertension, 41% were diabetic, 40% were concomitantly receiving either an angiotensin converting enzyme-inhibitor (ACE-I) or an angiotensin receptor blocker ( ARB), 40% were also being given diuretics, 72% received Ketorolac during the time of AKI and 3.8% of all patients who received Ketorolac developed hyperkalemia while on treatment. Conclusions: AKI occurs more commonly than previously anticipated in Ketorolac treated patients even at average doses and short durations. Hypertension and diabetes are the two most common comorbidities in patients who developed AKI. Those who are greater than 65 years old may be at higher risk. Concomitant use of drugs that affect renal function, such as ACE-I, ARBs and diuretics, may increase the risk of AKI. Ketorolac prescribing in the acute care hospital should consider individual comorbidities, and use of other drugs that can increase kidney failure risk. Awareness of current renal function through diligent review of daily labs may help prevent administration of Ketorolac in those with impaired renal function. Medication alerts that notifying the ordering physician of the eGFR may help prevent inadvertent prescription in those with AKI or chronic kidney disease . World J Nephrol Urol. 2014;3(3):113-117 doi: http://dx.doi.org/10.14740/wjnu169w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"3 1","pages":"113-117"},"PeriodicalIF":0.0,"publicationDate":"2014-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Varsha Podduturi, Hashim K Mohmand, J. Gill, Xin J. Zhou
Plasma cell leukemia (P CL) is a rare and aggressive malignancy of plasma cells with a poor prognosis. Direct renal involvement in PCL is rarely reported with only a few cases in the English literature. We described the clinical and pathologic findings of a 40-year-old African-American male with acute kidney injury (AKI) due to light-chain cast nephropathy and direct renal invasion by malignant plasma cells, diagnosed as having PCL on renal biopsy and successfully treated with aggressive plasmapharesis and allogeneic stem cell transplantation (SCT). To the best of our knowledge, this is the first case report of PCL diagnosed on kidney biopsy. Among the various clinical manifestations of PCL, AKI and proteinuria may be its initial presentation, illustrating the etiologic complexity of AKI. Successful treatment of cast nephropathy with plasma exchange and PCL by SCT was associated with recovery of renal function. World J Nephrol Urol. 2014;3(3):129-133 doi: http://dx.doi.org/10.14740/wjnu177w
{"title":"Plasma Cell Leukemia Presenting as Acute Kidney Injury With Heavy Proteinuria","authors":"Varsha Podduturi, Hashim K Mohmand, J. Gill, Xin J. Zhou","doi":"10.14740/wjnu177w","DOIUrl":"https://doi.org/10.14740/wjnu177w","url":null,"abstract":"Plasma cell leukemia (P CL) is a rare and aggressive malignancy of plasma cells with a poor prognosis. Direct renal involvement in PCL is rarely reported with only a few cases in the English literature. We described the clinical and pathologic findings of a 40-year-old African-American male with acute kidney injury (AKI) due to light-chain cast nephropathy and direct renal invasion by malignant plasma cells, diagnosed as having PCL on renal biopsy and successfully treated with aggressive plasmapharesis and allogeneic stem cell transplantation (SCT). To the best of our knowledge, this is the first case report of PCL diagnosed on kidney biopsy. Among the various clinical manifestations of PCL, AKI and proteinuria may be its initial presentation, illustrating the etiologic complexity of AKI. Successful treatment of cast nephropathy with plasma exchange and PCL by SCT was associated with recovery of renal function. World J Nephrol Urol. 2014;3(3):129-133 doi: http://dx.doi.org/10.14740/wjnu177w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"3 1","pages":"129-133"},"PeriodicalIF":0.0,"publicationDate":"2014-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Kashyap, Alfredo Harb De la Rosa, M. Soloway, M. Manoharan
Pelvic hematomas can form as a consequence of anticoagulant therapy after pelvic surgeries such as radical prostatectomy (RP). This can cause a significant disruption of the urethro-vesical anastomosis. We report a case of a 58-year-old male who presented with prostate cancer (PC) and underwent RP. Post-operatively, he developed deep vein thrombosis (DVT) and pulmonary embolism (PE). He was started on anticoagulant therapy which caused a pelvic hematoma resulting in the urethro-vesical anastomosis (UVA) disruption. World J Nephrol Urol. 2014;3(3):134-136 doi: http://dx.doi.org/10.14740/wjnu183w
{"title":"Pelvic Hematoma Due to Anticoagulant Therapy Causing Urethro-Vesical Anastomosis Disruption After Radical Prostatectomy: A Case Report","authors":"M. Kashyap, Alfredo Harb De la Rosa, M. Soloway, M. Manoharan","doi":"10.14740/WJNU183W","DOIUrl":"https://doi.org/10.14740/WJNU183W","url":null,"abstract":"Pelvic hematomas can form as a consequence of anticoagulant therapy after pelvic surgeries such as radical prostatectomy (RP). This can cause a significant disruption of the urethro-vesical anastomosis. We report a case of a 58-year-old male who presented with prostate cancer (PC) and underwent RP. Post-operatively, he developed deep vein thrombosis (DVT) and pulmonary embolism (PE). He was started on anticoagulant therapy which caused a pelvic hematoma resulting in the urethro-vesical anastomosis (UVA) disruption. World J Nephrol Urol. 2014;3(3):134-136 doi: http://dx.doi.org/10.14740/wjnu183w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"6 1","pages":"134-136"},"PeriodicalIF":0.0,"publicationDate":"2014-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anti-glomerular basement membrane (anti-GBM) disease is characterized by linear deposition of immunoglobulin G (IgG) along the GBM. The concurrence of anti-GBM disease with another type of glomerulonephritis has been well described. We report a case of necrotizing glomerulonephritis in association with prodromal systemic symptoms, deterioration in kidney function less rapid than expected, and the presence of circulating anti-GBM antibody. This was initially diagnosed histologically as immunoglobulin A (IgA) nephropathy based on immunohistochemistry (IHC) staining, but immunofluorescence (IF) staining on a subsequent biopsy was more consistent with a diagnosis of anti-GBM disease with co-existing mild IgA nephropathy. Prompt initiation of standard treatment of anti-GBM disease normalized kidney function. This case highlights that anti-GBM disease can present atypically and may also co-exist with another form of glomerulonephritis. World J Nephrol Urol. 2014;3(3):124-128 doi: http://dx.doi.org/10.14740/wjnu173w
{"title":"Hidden Tiger: An Atypical Presentation of Anti-Glomerular Basement Membrane Disease","authors":"A. Lecamwasam, Darren Lee, A. Skene, L. McMahon","doi":"10.14740/WJNU173W","DOIUrl":"https://doi.org/10.14740/WJNU173W","url":null,"abstract":"Anti-glomerular basement membrane (anti-GBM) disease is characterized by linear deposition of immunoglobulin G (IgG) along the GBM. The concurrence of anti-GBM disease with another type of glomerulonephritis has been well described. We report a case of necrotizing glomerulonephritis in association with prodromal systemic symptoms, deterioration in kidney function less rapid than expected, and the presence of circulating anti-GBM antibody. This was initially diagnosed histologically as immunoglobulin A (IgA) nephropathy based on immunohistochemistry (IHC) staining, but immunofluorescence (IF) staining on a subsequent biopsy was more consistent with a diagnosis of anti-GBM disease with co-existing mild IgA nephropathy. Prompt initiation of standard treatment of anti-GBM disease normalized kidney function. This case highlights that anti-GBM disease can present atypically and may also co-exist with another form of glomerulonephritis. World J Nephrol Urol. 2014;3(3):124-128 doi: http://dx.doi.org/10.14740/wjnu173w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"3 1","pages":"124-128"},"PeriodicalIF":0.0,"publicationDate":"2014-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gitelman syndrome (GS) is a recessive salt-losing tubulopathy due to a mutation of genes encoding the sodium chloride cotransporters and magnesium channels in the thiazide-sensitive segments of the distal convoluted tubule. In this paper we describe a 69-year-old lady with GS who presented with severe hyponatremia and hypocalcemia which are very rare complications associated with this syndrome. We are discussing the mechanisms involved in the development of these rare manifestations in this case report. World J Nephrol Urol. 2014;3(2):110-112 doi: http://dx.doi.o rg/10.14740/wjnu149 w
Gitelman综合征(GS)是一种隐性失盐小管病，由于编码远曲小管中噻嗪类药物敏感段的氯化钠共转运体和镁通道的基因突变而引起。在本文中，我们描述了一位69岁的GS女士，她表现为严重的低钠血症和低钙血症，这是与该综合征相关的非常罕见的并发症。在本病例报告中，我们正在讨论这些罕见表现发展的机制。世界肾癌杂志，2014;3(2):110-112 doi: http://dx.doi.o rg/10.14740/wjnu149 w
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