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Obstructiva Acute Kidney Injury with maintenance of diuresis: A Case of Ureter Bifidity

2019Journal article Open access
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dc.contributor.authorSilva, Francisca Gomes da
dc.contributor.authorRosa, Nuno
dc.contributor.authorPestana, Nicole
dc.contributor.authorSilva, Gil
dc.date.accessioned2022-01-06T17:03:08Z
dc.date.available2022-01-06T17:03:08Z
dc.date.issued2019
dc.description.abstractPercutaneous kidney biopsy in transplanted kidneys remains an essential and commonly performed procedure required for diagnostic and prognostic information. Hemorrhage is the main complication of renal graft biopsy. We report a case of a 47-year-old caucasian woman admitted to perform an ultrasound (US)-guided biopsy of the renal graft. Six hours later, she presented with macroscopic hematuria which improved after urethral catheterization and intravenous hydration. However the hematuria reappeared associated with anemia and worsening of the serum creatinine value. Te US study, revealed hydronephrosis with high Doppler derived renal resistive index compatible with clot obstruction. Despite the vesical lavage nd intravenous hydration. However the hematuria reappeared associated with anemia and worsening of the serum creatinine value. Te US study, revealed hydronephrosis with high Doppler derived renal resistive index compatible with clot obstruction. Despite the vesical lavage with drainage of several clots, the patient rapidly progressed to hemorrhagic shock with worsening of renal function. Pelvic computed tomography (CT) revealed calyx and pelvis duplicity and ureter bifdity which merged into a single ureter and inserted into the right anterolateral wall of the bladder. Te inferior ureter was enlarged due to an obstructive clot. Most acute obstructive uropathies are associated with signifcant pain or the abrupt diminution of urine fow. Te presence of ureter bifdity in the CT study explained the maintenance of signifcant diuresis despite obstruction, located only to the lower ureter but with sufcient functional impact to condition acute kidney injury (AKI).pt_PT
dc.description.abstractLa biopsia renal percutánea en riñones trasplantados sigue siendo un procedimiento esencial y común, necesario para obtener información diagnóstica y pronóstica. La hemorragia es la principal complicación de la biopsia de injerto renal. Presentamos un caso de una mujer caucásica de 47 años, quien fue hospitalizada para la realización de una biopsia de injerto renal guiada por ultrasonido (US). Seis horas después, presentó hematuria macroscópica que mejoró después de la cateterización uretral e hidratación intravenosa. Sin embargo, la hematuria reapareció asociada con anemia y empeoramiento del valor sérico de creatinina. El estudio de US reveló, mediante Doppler, una hidronefrosis con alto índice de resistencia renal, compatible con obstrucción por un coágulo. A pesar del lavado vesical con drenaje de varios coágulos, la paciente progresó rápidamente a choque hemorrágico con empeoramiento de la función renal. La tomografía computarizada (TC) pélvica reveló la duplicidad del cáliz y la pelvis y la bifdez ureteral, que se fusionó en un solo uréter y se insertó en la pared anterolateral derecha de la vejiga. El uréter inferior se agrandó debido a un coágulo obstructivo.La mayoría de las uropatías obstructivas agudas están asociadas con dolor signifcativo o la disminución abrupta del fujo de orina. La presencia de la bifdez del uréter en el estudio de TC explicó el mantenimiento de una diuresis signifcativa a pesar de la obstrucción, localizada solo en el uréter inferior, pero con sufciente impacto funcional como para provocar insufciencia renal aguda (IRA).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Nefrol Dial Traspl. 2019; 39 (4): 291-6pt_PT
dc.identifier.issn0326-3428
dc.identifier.issn2346-8548
dc.identifier.urihttp://hdl.handle.net/10400.26/38685
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherAsociación Regional de Diálisis y Trasplantes Renales de Capital Federal y Provincia de Buenos Aires Argetinapt_PT
dc.relation.publisherversionhttps://www.researchgate.net/publication/357538944pt_PT
dc.subjectpercutaneous kidney biopsypt_PT
dc.subjectmacroscopic hematuriapt_PT
dc.subjecthydronephrosispt_PT
dc.subjectacute Kidney Injurypt_PT
dc.subjectobstructive uropathypt_PT
dc.subjectdiminution of urine fowpt_PT
dc.subject: biopsia renal percutáneapt_PT
dc.subjecthematuria macroscópicapt_PT
dc.subjecthidronefrosispt_PT
dc.subjectlesión renal agudapt_PT
dc.subjecturopatía obstructivapt_PT
dc.subjectdisminución del fujo de orinapt_PT
dc.subjectbifdez del uréterpt_PT
dc.subjectRegião Autónoma da Madeirapt_PT
dc.subjectMadeira Islandpt_PT
dc.subjectPortugalpt_PT
dc.titleObstructiva Acute Kidney Injury with maintenance of diuresis: A Case of Ureter Bifiditypt_PT
dc.title.alternativeLESIÓN RENAL AGUDA OBSTRUCTIVA CON MANTENIMIENTO DE LA DIURESIS: UN CASO DE BIFIDEZ URETERALpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage296pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage291pt_PT
oaire.citation.volume39pt_PT
person.familyNamePestana
person.givenNameNicole
person.identifier.orcid0000-0002-7369-3026
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication1d2f7ca1-d253-4653-ba8e-e6e8392522a1
relation.isAuthorOfPublication.latestForDiscovery1d2f7ca1-d253-4653-ba8e-e6e8392522a1

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