Post-renal Failure

Chapter

Abstract

A 63-year-old male was seen for worsening hypertension and mild ankle edema. He was asymptomatic except for irregular urine output over the last few weeks. His blood pressure was 160/95 mmHg (no orthostatic changes), heart, lungs, and abdomen were normal, his prostate was modestly enlarged; and he had 1+ ankle edema. His serum potassium was 6.6 mEq/L, bicarbonate 15 mEq/L, and creatinine 5.8 mg/dL. His creatinine was 0.8 mg/dL 2 years earlier and 1.2 mg/dL 6 months earlier. He had 1+ proteinuria, microscopic hematuria, and his fractional excretion of sodium (FENa) was 1.5 %. Ultrasound showed an empty bladder, bilateral hydronephrosis and hydroureters, and moderate cortical thinning of the right kidney.

Keywords

Creatinine Bicarbonate Warfarin Myeloma Proteinuria 

References

  1. 1.
    Khlar S. Obstructive nephropathy. Intern Med. 2000;39(5):355–61.CrossRefGoogle Scholar
  2. 2.
    Rule AD, Lieber MM, Jacobsen SJ. Is benign prostatic hyperplasia a risk factor for chronic renal failure. J Urol. 2005;173:691–969.PubMedCrossRefGoogle Scholar
  3. 3.
    Tseng TY, Stoller ML. Obstructive uropathy. Clin Ger Med. 2009;25(3):437–43.CrossRefGoogle Scholar
  4. 4.
    Truong LD, Gaber L, Eknoyan G. Obstructive uropathy. Contrib Nephrol. 2011;169:311–26.PubMedCrossRefGoogle Scholar
  5. 5.
    Siddiqui MM, McDougal WS. Urologic assessment of decreasing renal function. Med Clin North Am. 2011;95(1):161–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Klahr S, Morrissey J. Obstructive nephropathy and renal fibrosis. Am J Physiol Renal Physiol. 2002;283:F861–F75.PubMedGoogle Scholar
  7. 7.
    Ravanon R, Tomson CRV. Natural history of postobstructive nephropathy: a single-center retrospective study. Nephron Clin Pract. 2007;105:c165–c70.CrossRefGoogle Scholar
  8. 8.
    Chevalier RL, Thornhill BA, Forbes MS, Kiley SC. Mechanisms of renal injury and progression of renal disease in congenital obstructive nephropathy. Pediatr Nephrol. 2010;25(4):687–97.PubMedCrossRefGoogle Scholar
  9. 9.
    Ingraham SE, McHugh KM. Current perspectives on congenital obstructive nephropathy. Pediatr Nephrol. 2011;26(9):1453–61.PubMedCrossRefGoogle Scholar
  10. 10.
    Halachmi S, Pillar G. Congenital urological anomalies diagnosed in adulthood-management considerations. J Pediatr Urol. 2008;4:2–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Nielson S, Kwon TH, Frokiaer J, Agre P. Regulation and dysregulation of aquaporins in water balance disorders. J Intern Med. 2007;261:53–64.CrossRefGoogle Scholar
  12. 12.
    Reddy S. State of the art trends in imaging renal of colic. Emerg Radiol. 2008;15:217–25.PubMedCrossRefGoogle Scholar
  13. 13.
    Webb JAW. Ultrasonography and Doppler studies in the diagnosis of renal obstruction. BJU Int. 2000;86 Suppl 1:25–32.PubMedGoogle Scholar
  14. 14.
    Theony HC, Binser T, Roth B, Kessler TM, Vermathen P. Noninvasive assessment of acute ureteral obstruction with diffusion-weighted MR imaging: a prospective study. Radiology. 2009;252(3):721–8.CrossRefGoogle Scholar
  15. 15.
    Uppot RN, Gervais DA, Mueller PR. Interventional uroradiology. Radiol Clin North Am. 2008;46:45–64.PubMedCrossRefGoogle Scholar
  16. 16.
    Uppot RN. Emergent nephrostomy tube placement for acute urinary obstruction. Tech Vasc Interv Radiol. 2009;12:154–61.PubMedCrossRefGoogle Scholar
  17. 17.
    Adamo R, Saad WEA, Brown DB. Management of nephrostomy drains and ureteral stents. Tech Vasc Interv Radiol. 2009;12:193–204.PubMedCrossRefGoogle Scholar
  18. 18.
    Abdel-Kadar K, Palevsky P. Acute kidney injury in the elderly. Clin Geriatr Med. 2009;25(3):331–58.CrossRefGoogle Scholar
  19. 19.
    Tseng TY, Stoller ML. Medical and medical/urologic approaches in acute and chronic urologic stone disease. Med Clin North Am. 2011;95(1):169–77.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of MedicineJ. Robert Cade FoundationCordobaArgentina
  2. 2.Division of Nephrology, Department of MedicineUniversity of Mississippi Medical CenterJacksonUSA

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