Case Reports in Nephrology最新文献

{"title":"Rifampin: The Cause of Acute Tubular Injury-A Case Report.","authors":"Muhammad Umer Arif, Areeba Farooq, Harjinder Singh, Muhammad Talha Javaid, Mudassar Hussain","doi":"10.1155/crin/7336365","DOIUrl":"https://doi.org/10.1155/crin/7336365","url":null,"abstract":"<p><p>Tuberculosis (TB) presents with fever, night sweats, and cough. The antituberculous therapy (ATT) used to treat TB affects various systems, including the renal system and the hepatobiliary system. ATT-induced acute tubular necrosis (ATN) can have various presentations, such as fever, vomiting, diarrhea, abdominal pain, oliguria, and cola-colored urine. We present a case of a 56-year-old patient using ATT. He presented with the complaint of altered mental status, vomiting, jaundice, and cola-colored urine. Labs revealed elevated liver enzymes, elevated creatinine, anemia, and thrombocytopenia. The autoimmune profile was normal; however, the biopsy revealed ATN. In addition to supportive management, hemodialysis and steroid therapy were initiated. Discontinuation of rifampin along with continuation of modified ATT therapy led to improved renal function tests, platelet counts, and Hb levels.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"7336365"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indirect Disaster-Related Deaths Among Hemodialysis Patients Following the Fukushima Daiichi Nuclear Power Plant Accident.","authors":"Ryoma Yoshida, Toyoaki Sawano, Yuna Uchi, Moe Kawashima, Kemmei Kitazawa, Hidenori Marui, Hiroki Yoshimura, Saori Nonaka, Naomi Ito, Chika Yamamoto, Toshiki Abe, Michio Murakami, Momoka Yamamura, Tianchen Zhao, Mamoru Sakakibara, Kazuko Yagiuchi, Mako Otsuki, Akihiko Ozaki, Tomoyoshi Oikawa, Shinichi Niwa, Masaharu Tsubokura","doi":"10.1155/crin/8847100","DOIUrl":"https://doi.org/10.1155/crin/8847100","url":null,"abstract":"<p><strong>Introduction: </strong>Disaster-related deaths (DRDs) are indirect fatalities caused by physical or psychological stress during evacuation. Patients undergoing hemodialysis (HD) face increased vulnerability during disasters due to reduced dialysis frequency, elevated mental stress, and limited access to medical resources. Although their risk is heightened, detailed analyses of DRDs in HD patients remain sparse.</p><p><strong>Methods: </strong>This retrospective study analyzed 13 HD-related DRD cases in Minamisoma City, Fukushima Prefecture, following the Fukushima Daiichi Nuclear Power Plant accident. A total of 520 DRDs were certified in the city. Data from local government records were extracted, focusing on time of death, causes of death, and psychiatric symptoms.</p><p><strong>Results: </strong>The mean age (± standard deviation) at death for HD patients was 77.92 (±8.37) years, which was younger than the mean age (± standard deviation) of 82.81 (±11.97) years among non-HD individuals (Welch's <i>t</i>-test, <i>p</i> = 0.060). Most deaths occurred during the chronic phase of the disaster. Primary causes included exacerbation of chronic kidney disease, cardiovascular complications, and sepsis. Over half of the patients exhibited psychiatric symptoms such as depression or mood instability.</p><p><strong>Discussion: </strong>This case series illustrates the severe impact of disruptions in medical care and the stress of repeated evacuations. Challenges include insufficient continuity of care and prolonged psychological distress, particularly during the chronic disaster phase. Our findings suggest that ensuring uninterrupted HD and providing long-term psychological support may be essential to mitigating DRDs in this population.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"8847100"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Remission of Late Relapsing Membranous Nephropathy After Previous Immunosuppressant-Induced Remission: Case Report.","authors":"Yangming Cao","doi":"10.1155/crin/6703642","DOIUrl":"https://doi.org/10.1155/crin/6703642","url":null,"abstract":"<p><p>This is the first detailed report of spontaneous remission of late relapsing membranous nephropathy (MN) after previous immunosuppressant-induced remission. In March 2004, a 52-year-old Hispanic male presented with severe nephrotic syndrome with proteinuria of 13 g/24 h. The workup for infectious and autoimmune diseases was unrevealing. Renal biopsy showed MN (Stage II). A CT scan showed no malignancy but left pulmonary embolism and left renal vein thrombosis. Anticoagulation was started for asymptomatic thromboembolism. He achieved sustained complete remission of nephrotic syndrome after a prolonged, complicated treatment course of multiple immunosuppressants (corticosteroids and mycophenolate mofetil for 1 year, followed by alternating monthly corticosteroids and chlorambucil for 6 months, and again corticosteroids and mycophenolate mofetil for 6 years). Then in July 2021 (now at the age of 69 years), he developed nephrotic syndrome again with proteinuria of 6 g/24 h. Serological work-up was all negative except for the elevated serum Antiphospholipase A2 receptor (PLA2R) antibody at 42 RU/mL (nl < 14). Renal biopsy in November 2021 showed again MN (Stage III to IV). Immunohistochemistry staining of the biopsy tissue for PLA2R1 antigen was positive. A decision was made to observe him instead of starting immunosuppressants. He was treated with diuretics and Lisinopril. Anti-PLA2R antibody steadily improved to normal range and the nephrotic syndrome gradually improved and finally resolved by August 2023. There was no recurrence of nephrotic syndrome up to the most recent visit in March 2026. A review of the literature shows that a repeat biopsy in patients already known to have MN (especially those PLA2R-mediated cases) with relapse of nephrosis and stable renal function may not be necessary. In routine practice, the watchful waiting strategy for relapse of MN is less often taken as it should be. Therefore, more patients with relapsing MN deserve an observation period before starting immunosuppressants. Hopefully, KDIGO guidelines can include this point for relapsing MN.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"6703642"},"PeriodicalIF":0.0,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Simultaneous Peritoneal Dialysis Catheter Removal and Reinsertion During Surgical Repair of Acute Small Bowel Perforation: A Case Report.","authors":"Pannawat Mongkolrattanakul, Chote Jitopas, Vatcharee Chareonphaibul, Kittiphan Chienwichai","doi":"10.1155/crin/8739668","DOIUrl":"https://doi.org/10.1155/crin/8739668","url":null,"abstract":"<p><p>Bowel perforation is a rare but serious complication of Tenckhoff catheter placement for peritoneal dialysis (PD), particularly when blind insertion techniques such as the Seldinger method are used. Standard management typically involves catheter removal, surgical repair of the bowel, and delayed reinsertion of a new catheter following completion of systemic antibiotic therapy. Although this approach minimizes the risk of infection, it necessitates a second surgical procedure and can significantly delay the initiation of PD. We report the case of a 60-year-old woman with end-stage kidney disease secondary to diabetic nephropathy who developed small bowel perforation during Tenckhoff catheter insertion via the Seldinger technique. To avoid a second operation, and in accordance with the patient's preference, simultaneous catheter removal and contralateral reinsertion were performed during surgical repair of the perforation. The peritoneal cavity was irrigated with 2.5 L of normal saline, a drain was placed, and the patient received a 14-day course of intravenous meropenem with peritoneal rest. The drain was removed on postoperative Day 5, and automated PD was successfully resumed two weeks later without any evidence of peritonitis. This case suggests that simultaneous catheter removal and reinsertion during bowel repair may be technically feasible under specific, favorable intraoperative conditions, potentially avoiding an additional procedure and facilitating earlier return to PD. However, this approach is not supported by current guidelines, which recommend delayed catheter reinsertion to allow adequate peritoneal healing, and should not be considered standard practice.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"8739668"},"PeriodicalIF":0.0,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"End-Stage Renal Disease Patient on Hemodialysis With Baclofen-Related Neurotoxicity and Pancreatitis.","authors":"Abdulaziz Alroshodi","doi":"10.1155/crin/5482934","DOIUrl":"https://doi.org/10.1155/crin/5482934","url":null,"abstract":"<p><strong>Background: </strong>Baclofen is a centrally acting muscle relaxant used orally and intrathecally for the management of spasticity, muscular spasms, and refractory hiccups. Baclofen is predominantly absorbed via the gastrointestinal tract, with over 80% excreted via the kidneys; hence, individuals with end-stage renal disease (ESRD) are at a heightened risk for baclofen toxicity. Baclofen can penetrate the blood-brain barrier, resulting in neurotoxicity. The potential of baclofen to induce acute pancreatitis is inadequately comprehended, with a limited number of instances documented in the medical literature. This report details an uncommon instance of an ESRD patient undergoing hemodialysis who had both baclofen-induced neurotoxicity and pancreatitis.</p><p><strong>Case presentation: </strong>We present a case of a 55-year-old woman who is known to have ESRD; she is currently on hemodialysis three times a week. After only two baclofen doses (10 mg, 12 h apart), given for chronic cervical pain, the patient developed a profound decrease in her level of consciousness (LOC). The next day, when her LOC had improved after dialysis, she reported nausea, vomiting, and epigastric abdominal pain as well. Her initial laboratory report showed an elevated amylase level. So, the assessment was a baclofen neurotoxicity in an ESRD patient, which was accompanied by mild-moderate pancreatitis after only two doses. Since baclofen is highly dialyzable, she was commenced on daily conventional hemodialysis using a high-flux dialyzer for three consecutive days. She did not require continuous dialysis. Her LOC improved dramatically after the second session, and she returned to her baseline just after the third session. However, she reported headache and hallucinations after. Pancreatitis symptoms improved with supportive measures later.</p><p><strong>Conclusion: </strong>The case highlights the need for increased awareness among healthcare providers about the potential risks of baclofen use, particularly in patients with ESRD. Even a small dosing can cause neurotoxicity. This is a very rare case of baclofen neurotoxicity accompanied by pancreatitis, who did respond very well to conventional hemodialysis. Patients with decreased renal function should avoid using baclofen, as its accumulation depends on renal excretion capacity.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"5482934"},"PeriodicalIF":0.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nephrotic-Nephritic Syndrome Following Unilateral Nephrectomy in Wilms Tumour in a Child.","authors":"Rawshan Zuhair Jaber","doi":"10.1155/crin/6427670","DOIUrl":"https://doi.org/10.1155/crin/6427670","url":null,"abstract":"<p><strong>Background: </strong>Wilms tumour (WT) represents the most frequent kidney malignant tumour in the paediatric population and is occasionally linked to specific congenital syndromes. Treatment typically includes multimodal therapy consisting of chemotherapy, surgery and/or radiotherapy (RT), with a success rate of approximately 90%. The incidence of nephrotic-nephritic syndrome following unilateral nephrectomy is extremely rare; however, certain long-term kidney complications have been documented.</p><p><strong>Case report: </strong>A 5-year-old female was diagnosed with WT, Stage 3 with favourable histology. She underwent left radical nephrectomy with preoperative spillage and received RT for the whole abdomen followed by chemotherapy. She was complaint from insidious onset fever, shortness of breath, progressive generalized oedema, reddish urine and headache, occurring 5 days from the 5^th cycle of chemotherapy and investigation confirm diagnosis of nephrotic-nephritic syndrome.</p><p><strong>Conclusion: </strong>Kidney injury poses a risk in cases following nephrectomy, with hyperfiltration, treatment toxicity and immune effects contributing to the condition. Early detection and management are essential for kidney preservation.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"6427670"},"PeriodicalIF":0.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reversible Nephrogenic Diabetes Insipidus Induced by Lithium: A Case Report.","authors":"Sevil Uygun İlikhan, Gülin Dilken, Gökhan Hazıroğlu, Sinem Ülke, Selma Karaahmetoğlu","doi":"10.1155/crin/9998067","DOIUrl":"https://doi.org/10.1155/crin/9998067","url":null,"abstract":"<p><p>Lithium is an effective mood stabilizer but may cause nephrogenic diabetes insipidus (NDI) by impairing the renal collecting duct response to arginine vasopressin (AVP). We report a 52-year-old woman on long-term lithium therapy who presented with diarrhea, fatigue, polyuria, and confusion. Initial evaluation showed hypernatremia (serum sodium 156-159 mmol/L), low urine osmolality (101 mOsm/kg) despite serum osmolality of 286 mOsm/kg, daily urine output of 6.5-7.5 L, and a lithium level of 1.65 mmol/L. Renal function was preserved. Intravenous 5% dextrose was administered for free-water replacement. Bicarbonate and potassium supplementation were initiated based on blood gas and biochemical findings consistent with metabolic acidosis (pH: 7.33 and serum bicarbonate: 22.1 mmol/L) and hypokalemia, requiring potassium supplementation. Lithium was discontinued, and a thiazide-containing regimen was initiated. Without desmopressin, serum sodium normalized to 140 mmol/L within 72 h, urine output decreased to approximately 2 L/day, and mental status fully recovered. This case demonstrates that timely recognition and management of lithium-induced NDI may allow recovery of urinary concentrating ability.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"9998067"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intersecting Autoimmunities: ANCA and Anti-GBM Overlap in a Patient With Sjögren's Disease.","authors":"Mayra Estacio, Joaquín Rodelo-Ceballos, Ligia Calderon, Alejandra Taborda-Murillo","doi":"10.1155/crin/2593770","DOIUrl":"https://doi.org/10.1155/crin/2593770","url":null,"abstract":"<p><strong>Background: </strong>The coexistence of antineutrophil cytoplasmic antibodies (ANCAs) and antiglomerular basement membrane (anti-GBM) antibodies defines a rare but clinically significant autoimmune overlap syndrome. This dual positivity can result in rapidly progressive glomerulonephritis, often with poor kidney outcomes. Diagnosis is particularly challenging in patients with underlying systemic autoimmune diseases, such as Sjögren's disease, where overlapping immunopathogenic mechanisms may obscure the clinical picture. Prompt recognition and individualized treatment are critical for optimal management.</p><p><strong>Case presentation: </strong>We describe a 62-year-old woman with a history of primary Sjögren's disease who presented with acute kidney injury and urinary abnormalities. Serologic tests revealed high titers of myeloperoxidase (MPO)-ANCA and anti-GBM antibodies, as well as ANA and anti-Ro/La positivity. Kidney biopsy demonstrated crescentic glomerulonephritis with linear IgG deposition and significant chronic changes. Immunosuppressive therapy with high-dose corticosteroids was initiated; however, due to advanced fibrosis and glomerulosclerosis, further immunosuppression was not pursued. The patient required dialysis but remained clinically stable during follow-up.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic and therapeutic challenges of dual ANCA and anti-GBM antibody positivity in the context of systemic autoimmunity. In patients with autoimmune disorders such as Sjögren's disease, a high index of suspicion is essential to detect this rare overlap, which often presents with severe kidney impairment. Although kidney prognosis is frequently poor, early identification and appropriate intervention are vital for improving clinical outcomes.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"2593770"},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-Onset Thiazide-Induced Hyponatremia Leading to Seizure in a Middle-Aged Woman Using Aldactazide.","authors":"Mehmet Zafer Aydın, Mehmet Kamil Teber, Zülfiye Kuzu, Mustafa Gök","doi":"10.1155/crin/9991770","DOIUrl":"10.1155/crin/9991770","url":null,"abstract":"<p><strong>Background: </strong>Thiazide-induced hyponatremia (TIH) is a well-recognized adverse effect of thiazide diuretics, typically occurring in elderly individuals. Severe acute hyponatremia presenting with seizures in middle-aged adults is uncommon. Combination therapy with spironolactone and hydrochlorothiazide (Aldactazide) may increase susceptibility to rapid electrolyte shifts. We report a case of early-onset, symptomatic hyponatremia leading to generalized seizure shortly after initiation of Aldactazide.</p><p><strong>Case presentation: </strong>A 52-year-old woman with hypertension presented after experiencing a generalized tonic-clonic seizure at home. She had started Aldactazide (spironolactone + hydrochlorothiazide 25 mg daily) 3 days earlier, in addition to perindopril/amlodipine and captopril. Two weeks before symptom onset, her serum sodium level was 131 mmol/L. On admission to the intensive care unit, she was alert and hemodynamically stable, with a Glasgow Coma Scale score of 15. Laboratory evaluation revealed severe hyponatremia (115 mmol/L), hypokalemia (3.3 mmol/L; ionized 2.7 mmol/L), and hypochloremia (76 mmol/L). Lactate was transiently elevated at 8.3 mmol/L, consistent with postictal physiology. Renal, thyroid, and adrenal functions were normal. Brain CT and MRI showed no acute abnormalities. Controlled correction with 3% hypertonic saline resulted in progressive normalization of serum sodium (115 ⟶ 121 ⟶ 125 ⟶ 131 mmol/L) without overcorrection. The patient experienced complete neurological recovery and was transferred to the nephrology ward for continued monitoring. Aldactazide was discontinued.</p><p><strong>Conclusion: </strong>This case demonstrates that TIH can develop rapidly in middle-aged individuals and may lead to life-threatening neurological complications, including seizures. Clinicians should closely monitor serum sodium during the early phase of thiazide-containing diuretic therapy, particularly when combination regimens such as Aldactazide are prescribed.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"9991770"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12934249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147302641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is it Always Safe to Administer RAS Inhibitors to Patients Who Underwent Unilateral Radical Nephrectomy?","authors":"Giulio Romano, Alessandro Crestani, Giuseppe Como, Erika Cucchiaro, Nicholas Fiorini, Gianluca Colussi","doi":"10.1155/crin/5481521","DOIUrl":"https://doi.org/10.1155/crin/5481521","url":null,"abstract":"<p><p>Compensatory increases in single-kidney glomerular filtration rate (GFR) are usually observed after unilateral radical nephrectomy. However, the influence of hemodynamically active therapies on early functional compensation remains uncertain. We describe a 65-year-old man with latent autoimmune diabetes of adulthood, nonproteinuric chronic kidney disease consistent with atherosclerotic nephropathy, and mildly reduced baseline renal function who underwent right radical nephrectomy with caval thrombus removal for clear cell renal cell carcinoma. Based on preoperative split renal function, a postnephrectomy GFR above 45 mL/min was anticipated. Despite continued treatment with ramipril and dapagliflozin, GFR at 3 months remained close to the immediate postoperative value. After discontinuation of both agents, GFR increased above the expected threshold and remained stable, without albuminuria. This observation is hypothesis-generating and suggests that combined ACE and SGLT2 inhibition may transiently attenuate early functional compensation through hemodynamic mechanisms, particularly in patients with atherosclerotic nephropathy, supporting individualized perioperative management and close renal function monitoring.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2026 ","pages":"5481521"},"PeriodicalIF":0.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}