Efficacy of daprodustat on anemia in hemodialysis patients with sustained inflammation: a case report
AbstractHypoxia-inducible factor prolyl hydroxylase inhibitors improve anemia in CKD and dialysis patients and were approved for anemia treatment with these populations in Japan. An 89 year-old man with anemia and on maintenance hemodialysis was successfully treated with a dose-up of darbepoetin alfa from 10 to 20 μg per week, and the dose was gradually tapered to 5 μg. Later, serum hemoglobin levels decreased with the newly occurring sustained inflammation and left pleural effusion of an unknown cause, and the darbepoetin alfa dose was increased again to 20 μg per week, which was not effective. Darbepoetin alfa wa...
Source: CEN Case Reports - May 9, 2022 Category: Urology & Nephrology Source Type: research
Proteinuria from first-morning urine in a child due to brace treatment for adolescent idiopathic scoliosis
We report the case of a 12-year-old Japanese girl who was referred to our pediatric department for asymptomatic proteinuria detected during a school urinary screening. Proteinuria was found only on the first-morning urinalysis and not on the routine urinalysis. The patient had been diagnosed with adolescent idiopathic scoliosis and treated with a nighttime brace. As excess protein was not detected on urinalysis of the first-morning urine sample that was collected after a night without the brace, proteinuria due to the brace treatment for scoliosis was diagnosed. The present case revealed that brace treatment can cause prot...
Source: CEN Case Reports - May 9, 2022 Category: Urology & Nephrology Source Type: research
Acute pericarditis after COVID 19 in a peritoneal dialysis patient
AbstractCOVID-19 is known to affect numerous organs which have ACE-2 receptors, lung being the most involved organ. Nevertheless, cardiac involvement is not uncommon and can occur through a variety of manifestations. The authors hereby report a case of pericarditis following SARS-CoV-2 infection. A 54-year-old man with end stage kidney disease under peritoneal dialysis presented with acute chest pain approximately 1 month after being diagnosed with COVID-19. Electrocardiogram revealed widespread ST segment elevation. The diagnosis of acute pericarditis secondary to the viral infection was made and the patient was treated...
Source: CEN Case Reports - May 4, 2022 Category: Urology & Nephrology Source Type: research
Pregnancy-onset thrombotic thrombocytopenic purpura with nephrotic syndrome: a case report
AbstractPregnancy-onset thrombotic thrombocytopenic purpura (TTP) was reported by many obstetricians and hematologists, but less by nephrologists, and the detailed clinical course of its renal complication is not known. Here, we report a case of a 33-year-old pregnant woman who suffered from pregnancy-onset TTP with nephrotic syndrome which was controlled by the termination of pregnancy. On admission, she had periorbital and lower leg edema at 32 weeks of gestation. Her serum albumin level was 2.8 g/dL and the urine protein/creatinine ratio was 4.1 g/g Cr. Besides those, she had thrombocytopenia, hemolytic anemia, and ...
Source: CEN Case Reports - May 1, 2022 Category: Urology & Nephrology Source Type: research
Effectiveness and safety of rehabilitation on minimal change nephrotic syndrome in remission for elderly patients with low activity of daily living: a case report
AbstractThere are few reports on the rehabilitation of elderly patients with minimal change nephrotic syndrome (MCNS). The purpose of this case study was to evaluate the efficacy and safety of rehabilitation for an elderly patient with MCNS in remission. The patient was an 86-year-old woman. She was admitted to the hospital with a diagnosis of MCNS, and steroid treatment was initiated. She was weaned from dialysis 2 weeks later; however, her activities of daily living (ADL) decreased, and she developed disuse syndrome. After rehabilitation, the patient’s ADL, maximum hand grip strength, and gait function improved. The...
Source: CEN Case Reports - May 1, 2022 Category: Urology & Nephrology Source Type: research
A case of proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) that responded favorably to steroid therapy
AbstractProliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) generally has a poor prognosis and the consensus is that it needs to be treated with clone-directed therapy. However, the prognosis of PGNMID is heterogenous and some cases have been successfully treated using other therapeutic strategies. We herein report a case of PGNMID that responded favorably to steroids without clone-directed therapy. An 18-year-old woman was referred to a nephrologist with proteinuria detected in an annual health check-up. Over a 3-year period, the concentration of creatinine (Cr) increased from 0.76 to 1.00 ...
Source: CEN Case Reports - May 1, 2022 Category: Urology & Nephrology Source Type: research
A case of early onset cystinuria in a 4-month-old girl
AbstractCystinuria is an autosomal recessive disorder characterized by a decrease in the reabsorption of cystine and dibasic amino acids (lysine, ornithine, and arginine) in the renal proximal tubule. It presents with recurrent urolithiasis. Cystinuria accounts for 6 –8% of all pediatric urolithiasis. The age of onset is typically 10–30 years. Here, we report a case of early-onset cystinuria. A 4-month-old girl presented with hematuria. We noticed multiple renal calculi in ultrasonography and abdominal computerized tomography scans. The diagnosis was cystin uria with urinary calculus analysis and urinary amino acid an...
Source: CEN Case Reports - May 1, 2022 Category: Urology & Nephrology Source Type: research
A case of 1-month-old female infant delaying peritoneal dialysis introduction by low-potassium anti-allergic formula treated with sodium polystyrene sulfonate
AbstractThe 8806H formula is the only renal formula available for pediatric patients with chronic kidney disease in Japan. A 1-month-old female infant could not be administered 8806H because of milk allergy. Administration of low-potassium anti-allergic formula treated with sodium polystyrene sulfonate maintained adequate serum potassium levels, and introduction of peritoneal dialysis could be delayed. The patient had severe renal dysfunction secondary to bilateral hypoplastic and multi-cystic kidneys. Although she received the 8806H formula, this product was switched to hydrolyzed casein formula because she developed alle...
Source: CEN Case Reports - April 20, 2022 Category: Urology & Nephrology Source Type: research
A de novo case of minimal change disease following the first dose of the Moderna mRNA-1273 SARS-CoV-2 vaccine without relapse after the second dose
AbstractIn recent times, new onset or relapse of nephrotic syndrome following the first dose of SARS-CoV-2 vaccines has been reported. Although the vaccination could trigger nephrotic syndrome, the question of whether the same vaccine should be administered as the second dose remains unanswered. A 25-year-old woman had taken the Moderna mRNA-1273 SARS-CoV-2 vaccine (mRNA-1273) and 26 days later, she noticed facial and peripheral edema. One week later she was referred and admitted to our hospital, wherein laboratory tests revealed that her serum creatinine level, serum albumin level, and urine protein–creatinine ratio w...
Source: CEN Case Reports - April 18, 2022 Category: Urology & Nephrology Source Type: research
The new method to make diagnosis and identify the location of leakage of pleuroperitoneal communication in peritoneal dialysis patients
We report three cases of pleuroperitoneal communication in peritoneal dialysis patients, in which we found the combination of contrast-enhanced ultrasonography and the indocyanine green fluorescence system are reliable method to make diagnosis and identify the location of leakage of pleuroperitoneal communication. By making definite diagnosis and precise ly identifying the localization, we were able to close diaphragm holes by video-assisted thoracoscopic surgery. (Source: CEN Case Reports)
Source: CEN Case Reports - April 15, 2022 Category: Urology & Nephrology Source Type: research
Emergence of proteinase 3-antineutrophil cytoplasmic antibody-associated glomerulonephritis with mesangial immune deposition during the clinical course of IgG λ monoclonal gammopathy of uncertain significance
We report the case of a 68-year-old man developed nephritic syndrome and mild renal insufficiency during the course of IgG λ MGUS. Laboratory findings showed hypocomplementemia, cryoglobulinemia, proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) positivity and monoclonal proteins (λ light chain and λ-Bence-Jones protein) in the urine. A kidney biopsy revealed crescentic glomerulonephritis with mesangial imm une deposits without paraproteins. Treatment with prednisolone for ANCA-associated glomerulonephritis, normalized urinalysis and decreased PR3-ANCA but MGUS persisted. This is a rare case of PR3-ANCA-associ...
Source: CEN Case Reports - April 14, 2022 Category: Urology & Nephrology Source Type: research
Concomitant occurrence of pyelocalyceal diverticulum and ipsilateral large sized orthotopic ureterocele in an adult: a rare association
We report a case of concomitant occurrence of pyelocalyceal diverticulum and ipsilateral large sized orthotopic ureterocele diagnosed on high-resolution ultrasonography and confirmed on contrast enhanced computed tomography in a 54-year-old adult female. The patient underwent resection of the ureterocele with insertion of left sided double-J ureteral stent which was left in place for 4 weeks following which the patient ’s symptoms improved and she was discharged after an uneventful post-operative recovery period. (Source: CEN Case Reports)
Source: CEN Case Reports - April 13, 2022 Category: Urology & Nephrology Source Type: research
Cooccurrence of Alport syndrome and poststreptococcal acute glomerulonephritis with improvement after steroid administration
AbstractIt is clinically possible for patients with Alport syndrome (AS) to suffer from poststreptococcal acute glomerulonephritis (PSAGN). However, there is only one report of such a patient, and he had end-stage kidney disease. Here, we describe an 8-year-old male with X-linked AS and chronic kidney disease (CKD) stage G2. He presented with diffuse edema, gross hematuria, proteinuria, and body weight gain after streptococcal pharyngitis. Blood examination showed kidney dysfunction, hypocomplementemia, and increased anti-streptolysin-O levels. His kidney function did not improve with symptomatic treatment. Therefore, we s...
Source: CEN Case Reports - April 10, 2022 Category: Urology & Nephrology Source Type: research
Light chain deposition disease masquerading as smoking-associated nodular glomerulosclerosis with deposits identified by electron microscopy only
We report this case to illustrate that within the differential diagnosis of nodular sclerosis, monoclonal immunoglobulin deposition disease (MIDD) should remain in the differential even if immunofluorescence appears negative as EM can prove to be crucial in identifyin g cases of MIDD. (Source: CEN Case Reports)
Source: CEN Case Reports - March 22, 2022 Category: Urology & Nephrology Source Type: research
A non-immunocompromised host with nontuberculous mycobacteria-associated tubulointerstitial nephritis
This report describes a rare instance of nontuberculous mycobacteria-associated tubulointerstitial nephritis in a patient without a history of HIV infection or organ transplantation. In differential diagnosis of granulomatous tubulointerstitial nephritis, clinicians should consider drugs, sarcoidosis, tubulointerstitial nephritis and uveitis syndrome, vasculitis, and infections (e.g., involving mycobacteria). Prompt microbiological examinations, especia lly of urine or biopsy cultures, are vital for diagnosis. (Source: CEN Case Reports)
Source: CEN Case Reports - March 16, 2022 Category: Urology & Nephrology Source Type: research
