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Exercise-Induced Acute Renal Failure (ALPE)

Abstract

The first patient to be recognized as having this condition was a 29-year-old man [1]. On August 20, 1979, he attended an emergency outpatient unit at night with severe loin pain. His serum creatinine level was slightly increased (1.6 mg/dl). Under a tentative diagnosis of ureteral stone, an intravenous pyelography (IVP) was performed. However, there was no stone. Plain computed tomography (CT) 22 hafter the administration of a contrast medium (delayed CT: plain CT several hours or days after the administration of a contrast medium) (Fig. 2) showed patchy wedge-shaped contrast enhancement in the bilateral kidneys (the first image in a human). This persisted for 48 h after administration of the medium (Fig. 3) [1]. A kidney biopsy 2 weeks after onset suggested acute tubular necrosis (Fig. 4). At the same time, we were conducting an experiment involving an infusion of microspheres into a rat heart and glomerular supervital staining with Alcian blue, and we found some wedge-shaped lesions. As this finding suggested renal infarction (Fig. 5), we speculated that the wedge-shaped contrast enhancement in our patient was associated with a vascular lesion (vasoconstriction).

Keywords

Alcian Blue Acute Tubular Necrosis Ureteral Stone Plain Compute Tomography Loin Pain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer 2007

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