Case Reports in Nephrology最新文献

{"title":"Intravenous Misplacement of the Nephrostomy Catheter Into the Renal Vein Following Percutaneous Nephrolithotomy (PCNL): A Case Report and Literature Review.","authors":"Shuah Ullah, Hammad Ur Rehman Shamsi, Ayesha Kamran, Abdullah Ayub, Dania Masood","doi":"10.1155/crin/1229960","DOIUrl":"https://doi.org/10.1155/crin/1229960","url":null,"abstract":"<p><p><b>Background:</b> After percutaneous nephrolithotomy (PCNL), intravenous misplacement of a nephrostomy tube is a very rare clinical occurrence. This report summarizes the characteristics and management of intravenous misplacement of a nephrostomy tube. <b>Case Presentation:</b> We present a rare case of intravenous nephrostomy catheter misplacement after PCNL in a 63 years old male. The tip of the tube was located in the left renal vein. The patient was managed conservatively and treated safely. <b>Conclusion:</b> Intravenous nephrostomy tube misplacement is a rare PCNL complication. Good Imaging can rule out through and through renal vein perforation and thus patients can be safely managed using conservative approach.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2025 ","pages":"1229960"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149277","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":"Oxcarbazepine Induced Rhabdomyolysis and Acute Kidney Injury: A Case Report.","authors":"Sara Yavuz Ileri, Nuray Can Usta","doi":"10.1155/crin/4168888","DOIUrl":"10.1155/crin/4168888","url":null,"abstract":"<p><p>The cause of acute skeletal muscle damage, defined as rhabdomyolysis, is multifactorial. Medicines are prominent among the most important reasons. The clinical significance of rhabdomyolysis lies in the fact that it can cause acute kidney injury (AKI) in 10%-40% of patients. In this presented case, oxcarbazepine, which is a preferred drug in the treatment of epilepsy and also in neuropathic pain in clinical practice, triggered rhabdomyolysis and subsequently caused the development of AKI. Through this case report, we aimed to emphasize that some serious side effects should not be forgotten when prescribing drugs in clinical practice.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2025 ","pages":"4168888"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141380","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":"BRASH Syndrome: A Patient With Chronic Kidney Disease and AV Nodal Blockers.","authors":"Zein A Alsayed-Ahmad, Sanaa Saddour, Tasnim Mustafa Saddour, Mohamad Moafak Hariri, Karam Albitar, Sami Albitar","doi":"10.1155/crin/3405566","DOIUrl":"10.1155/crin/3405566","url":null,"abstract":"<p><p><b>Background:</b> BRASH syndrome is a life-threatening condition that involves bradycardia, renal failure, atrioventricular blockade, shock, and hyperkalemia. It is often resistant to conventional treatments and requires prompt diagnosis and management. We report a case of BRASH syndrome successfully treated in the Emergency Department and Nephrology Department. <b>Case Presentation:</b> A 57-year-old man with hypertension, diabetes, ischemic heart disease, and chronic kidney disease presented with severe diarrhea, lethargy, and shock. He had hyperkalemia, metabolic acidosis, and acute kidney injury. His electrocardiogram showed sinus bradycardia with complete AV block. He was on bisoprolol, which was discontinued. He received hemodialysis, potassium-lowering agents, and vasoactive drugs. His renal function improved, and his heart rate normalized with first-degree AV block. He was discharged with advice to avoid AV-blocking agents and follow-up with nephrology and cardiology. <b>Conclusions:</b> BRASH syndrome is a serious complication of hyperkalemia, hypotension, and bradycardia in patients with kidney dysfunction and AV-blocking medications. It may require hemodynamic support and temporary pacemaker insertion. Early recognition and treatment of this entity can reduce mortality and morbidity.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2025 ","pages":"3405566"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101477","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":"Remarkable Improvement in Kidney Function in a 93-Year-Old ESKD Patient Under Home Hospice Care.","authors":"Alster Talia, Beizer Reshit, Azulay Daniel","doi":"10.1155/crin/7796641","DOIUrl":"https://doi.org/10.1155/crin/7796641","url":null,"abstract":"<p><p>This report details the remarkable improvement in kidney function and quality of life in an ESKD 93-year-old male patient under conservative management in Israel. The patient, with previous postrenal obstruction due to prostate enlargement and recurring infections, exhibited significant kidney deterioration, reaching a creatinine level of 7.6 mg/dL and a GFR of 6.7 mL/min/1.73 m² in December 2023. Following numerous hospitalizations and ER visits over the previous year, the patient opted for palliative care, prioritizing life quality over life-extending interventions. Over a 6 month period (December 2023-May 2024), the patient received comprehensive palliative care: nurse visits, bimonthly doctor consultations, and medication adjustments based on biochemical home blood tests. Despite initial severe kidney impairment, the patient's creatinine levels improved to 3.2 mg/dL and GFR increased to 18.2 mL/min/1.73 m². Potassium and phosphorus stabilized, and no further ER visits were recorded. Clinically, the patient showed enhanced cognition, memory, and communication and managed peripheral edema effectively. This case underscores the potential benefits of conservative palliative management in an Israeli elderly patient, a phenomenon that is recognized in the US and Canada more often, but not highlighted in the Middle Eastern elderly population. Coordinated efforts of a skilled palliative care team and supportive home hospice care contributed to the patient's clinical improvement. These findings challenge the notion that is often communicated to Israeli ESKD patients, Hatoum and Sperling, that palliative treatment leads to further kidney function deterioration, suggesting that, in some cases, it can result in improved outcomes in an underreported population.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2025 ","pages":"7796641"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966643","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":"Cefepime Neurotoxicity in Acute Kidney Injury: The Importance of Renal Dosing.","authors":"Andrew Lurie, Daniela Carralero Somoza, Graciela Luna, Kaitlyn Cariaga, Umair Syed Ahmed","doi":"10.1155/crin/2274647","DOIUrl":"https://doi.org/10.1155/crin/2274647","url":null,"abstract":"<p><p>Cefepime is widely used in sepsis owing to its broad spectrum of activity with coverage against <i>Pseudomonas</i>. Though it is usually well-tolerated, in the presence of certain risk factors, renal impairment, high doses, and critical illness, it is associated with the development of neurotoxicity. Those most susceptible are at high risk for developing complications of their underlying illness and the clinical manifestations of cefepime-related neurotoxicity are nonspecific, with reduced level of consciousness, confusion, myoclonus, and seizures, thus a high index of suspicion is required to make a diagnosis. The management includes drug discontinuation, seizure prophylaxis in the right clinical setting, and hemodialysis in severe cases. This case reinforces the need to renally adjust medications in the setting of acute kidney injury to avoid uncommon complications while using common medications.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2025 ","pages":"2274647"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979233","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 Gynecomastia Induced by Darbepoetin in a Patient With Chronic Kidney Disease.","authors":"Randah Abdullah Dahlan, Maram Khalid Sait, Alaa Khalil Monjed","doi":"10.1155/crin/6653329","DOIUrl":"https://doi.org/10.1155/crin/6653329","url":null,"abstract":"<p><p>Gynecomastia is a benign proliferation of the glandular tissue of the male breast. It is a common physiological condition during infancy and puberty and typically resolves spontaneously in most cases. However, adult-onset gynecomastia requires proper evaluation to identify the underlying cause. Several medications are associated with gynecomastia in adults, with some having a clear pathophysiologic mechanism while others do not. We report a 78-year-old male with chronic kidney disease (CKD) who developed painful gynecomastia following the administration of darbepoetin. The gynecomastia resolved upon cessation of darbepoetin but recurred upon its reintroduction. Extensive evaluation did not identify any other underlying cause. To our knowledge, this is the first case describing an association between darbepoetin and gynecomastia. In addition to presenting the case, we briefly discuss the hormonal changes in CKD patients and the potential effects of synthetic erythropoiesis-stimulating agents (ESAs) on hormone regulation.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2025 ","pages":"6653329"},"PeriodicalIF":0.0,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985732","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":"The Role of Angiotensin-II Infusion in an Infant With Autosomal Recessive Polycystic Kidney Disease Postbilateral Nephrectomies and Refractory Hypotension in the Neonatal Period.","authors":"Ana Nevarez Gilbert, Adrianne Rahde Bischoff, Kyle Merrill","doi":"10.1155/crin/1431773","DOIUrl":"10.1155/crin/1431773","url":null,"abstract":"<p><p>Autosomal recessive polycystic kidney disease (ARPKD) is a form of hereditary cystic disease with a highly variable phenotypic expression that ultimately leads to chronic kidney disease. Severe cases may warrant surgical intervention with unilateral or bilateral nephrectomy to alleviate thoracic and abdominal compression from massive nephromegaly. Hypotension has been identified as a potential complication following nephrectomy in pediatric patients. We present the case of an infant with end-stage kidney disease secondary to ARPKD who developed refractory hypotension following elective bilateral nephrectomies. We describe the use of angiotensin-II infusion with a significant increase in mean arterial blood pressure and successful reduction in other inotropic and vasopressor support. This case suggests that angiotensin-II may represent another valuable therapeutic agent in the treatment of refractory hypotension in anephric infants.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2025 ","pages":"1431773"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751242","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":"Mending the Valve, Burdening the Kidney: A Case of Renal Hemosiderosis With Mitral Valve Repair.","authors":"Sadikshya Bhandari, Tenzin Tamdin, Raymond Raut","doi":"10.1155/crin/2777348","DOIUrl":"10.1155/crin/2777348","url":null,"abstract":"<p><p>Renal hemosiderosis, marked by the buildup of hemosiderin in the renal cortex due to chronic intravascular hemolysis, can lead to acute kidney injury. Iron deposited may exacerbate renal damage through processes like lipid peroxidation and free radical formation, impacting cellular function and precipitating renal disease. Although seen commonly with chronic intravascular hemolysis in the setting of sickle cell anemia, thalassemia, and in the setting of prosthetic cardiac valves. While acute renal failure following prosthetic cardiac valve placement is relatively uncommon, some cases of renal injury in the setting of mechanical hemolysis have been reported, in the postsurgical period, typically within 2 weeks. In this case report, we present a 67-year-old male patient, following mitral valve repair, who developed anemia within 2 weeks of the repair. Evaluation with echocardiography did not initially show findings of worsening mitral regurgitation, however, his anemia and kidney function worsened over the next 6 months. Further evaluation, during that time showed worsening mitral valve regurgitation in repeated echocardiography, with renal hemosiderosis confirmed via kidney biopsy, revealing glomerulosclerosis with hemosiderin deposits. Due to persisting anemia and worsening kidney function, the patient is being planned for a mitral valve replacement. The potential recovery of renal function remains uncertain. Despite the common occurrence of intravascular hemolysis following prosthetic valve placement or valve repair, only a few cases of acute renal failure have been reported. In these cases, severe hemolytic anemia developed shortly after surgery, within 2 weeks, with increased levels of creatinine, even reported as high as 8.2 mg/dL and renal biopsy revealed acute tubular injury and widespread tubular hemosiderosis, resembling the findings in the index case. Diagnosis depends on the evaluation of anemia, showing signs of hemolysis, with echocardiology findings of worsening valvular abnormalities, and kidney biopsy findings showing hemosiderin deposits. Treatment strategies encompass the management of anemia alongside considerations for either mitral valve replacement or repair. This case underscores the importance of considering the possibility of renal hemosiderosis, associated with mitral valve repair. The delay in diagnosis observed in this case is not uncommon, and timely recognition becomes pertinent to prevent irreversible renal injury and improve long-term outcomes.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2025 ","pages":"2777348"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718042","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":"Alport Syndrome Presenting as Incidental Finding of Proteinuria on Pre-Employment Checkup: A Case Report.","authors":"Abigayle Therese R Guiritan, Lee-Boyd D Valencia, Sonia L Chicano","doi":"10.1155/crin/9933123","DOIUrl":"https://doi.org/10.1155/crin/9933123","url":null,"abstract":"<p><p><b>Introduction:</b> Glomerulonephritis is a prominent cause of chronic kidney disease and encompasses a subset of renal diseases characterized by immune-mediated damage to the basement membrane, the mesangium, or the capillary endothelium. Symptoms in early stages are usually nonspecific and can be easily overlooked. Unfortunately, if not detected early, this may lead to end-stage renal disease. We present a case of a 23-year-old male patient with no family of kidney disease who had proteinuria on routine urinalysis. <b>Case Presentation:</b> A 23-year-old male, nonhypertensive and nondiabetic, with no family history of kidney disease coming in for proteinuria. During pre-employment checkup, patient was noted to have 4+ proteinuria on urinalysis. Creatinine was requested by company doctor with result of 1.05 mg/dL (eGFR: 104 mL/min/1.73 m²). Repeat urinalysis was done but still with 4+ proteinuria on urinalysis. Hence, advised consult with a nephrologist due to persistence of proteinuria. Upon consult, workups were done, which revealed hyperuricemia, urate crystals on urinalysis, persistence of 4+ proteinuria, and urine protein creatinine ratio of 2.8 (urine protein: 223.28 mg/dL and urine creatinine: 79.64 mg/dL). Patient was started on ACE inhibitor, hypouricemic agent, and advised kidney biopsy for further evaluation of proteinuria. The review of systems was pertinent for hearing impairment and blurring of vision. Kidney biopsy was done in which electron microscopy showed segmental podocyte foot process effacement. The glomerular basement membrane shows lamellation and alternate thickening and thinning. No definite electron-dense deposits are seen in glomerular basement membrane and mesangium. Mean glomerular basement membrane thickness is 299 nm (normal mean glomerular basement membrane thickness in adult males is 373 ± 42 nm). He was advised consult with an ophthalmologist and otolaryngologist. Regular checkup, monitoring of renal parameters, and appropriate medications were given. <b>Conclusion:</b> Although a rare cause of glomerulonephritis, Alport syndrome must be considered in patients presenting with subnephrotic range proteinuria and microscopic hematuria. Thorough history and physical examination and characteristic findings on kidney biopsy can help in the prompt diagnosis of the disease. Multidisciplinary care and early intervention can improve the quality of life and delay the progression to end-stage kidney disease among these patients.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2025 ","pages":"9933123"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977329","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":"Overlap Syndrome in Late-Onset Systemic Lupus Erythematosus With Lupus Nephritis and MPO-ANCA Pauci-Immune Glomerulonephritis and Tuberculosis: An Uncommon Association.","authors":"Jaime Arturo Dulce Muñoz, Gustavo José Aroca Martínez, Christian David Seni Hernández, Diana Marcela Perea Rojas, Omar Cabarcas Barbosa, Lucia Mercedes Niño Hernández, Dario Jose Gaivao Arciniegas, Camila María García Jarava, Marianela Olivares Olmos, Sebastian Andre Seni Hernández, Valentina Pérez Jiménez, Indiana Luz Rojas Torres","doi":"10.1155/crin/5285961","DOIUrl":"https://doi.org/10.1155/crin/5285961","url":null,"abstract":"<p><p>Systemic lupus erythematosus is a systemic autoimmune pathology that generally presents in young people and manifests acutely, while its late presentation in people over 50 years of age is rare and insidious. Vasculitis is a pathology that affects any vessel producing fibrinoid necrosis, and presents with a positive antineutrophil cytoplasmic antibody. The concomitance of these two entities is rare and leads to worse clinical outcomes. We present a 73-year-old female patient who presented with rapidly progressive glomerulonephritis requiring renal replacement therapy, pulmonary tuberculosis, late-onset lupus erythematosus with lupus nephritis, and a positive result for neutrophil cytoplasmic antibody. An immune-mediated extracapillary proliferative glomerulonephritis was found when the biopsy was performed, with obvious signs of vasculitis, an overlap syndrome was found between these entities. She was initially treated with antituberculosis therapy, boluses of methylprednisolone and continued with intermittent renal replacement therapy; however, due to the severity of his pathologies, she had a fatal outcome. The concomitance between these autoimmune pathologies is unusual; there is a late-onset overlap syndrome between lupus nephritis accompanied by myeloperoxidase-antineutrophil cytoplasmic antibody and pauci-immune glomerulonephritis. The dual presentation establishes clinical challenges for its diagnosis as well as the initiation of immunosuppressive therapy when there are additional infectious pathologies.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":"2025 ","pages":"5285961"},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962092","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}