A case of peritoneal dialysis-related peritonitis caused by dialysate leakage with successful treatment by intravenous and intraperitoneal antibiotic therapy
AbstractDialysate leakage is one of the causes of peritoneal dialysis (PD)-related peritonitis. The rate of catheter removal in PD-related peritonitis caused by dialysate leakage (PDPDL) is high, and the correct treatment is unclear. We experienced a case of PDPDL that was treated with intravenous and intraperitoneal antibiotic therapy. A 44-year-old Japanese man had high glucose discharge from the exit site after 14 days of initiating PD, and he had a fever and cloudy effluent with a high white cell count. We diagnosed him with PDPDL and began to administer vancomycin and ceftazidime intraperitoneally. However, the peri...
Source: CEN Case Reports - September 12, 2021 Category: Urology & Nephrology Source Type: research
Focal segmental glomerulosclerosis and concurrent glomerular microangiopathy after long-term imatinib administration
AbstractA 79-year-old Japanese man was admitted to our hospital because of proteinuria and kidney dysfunction. He was diagnosed with chronic myeloid leukemia 13 years before and was treated with imatinib. Deep molecular response was achieved but he developed 1+ proteinuria in the first year, which gradually worsened thereafter. Imatinib was discontinued 12 years later but proteinuria and kidney dysfunction were progressive. Percutaneous kidney biopsy rev ealed mild mesangial hyper-cellularity and matrix increase, swelling of endothelial cells, and partial double contours of glomerular tufts. Subendothelial edema in the ...
Source: CEN Case Reports - September 9, 2021 Category: Urology & Nephrology Source Type: research
Membranous nephropathy in a patient with pulmonary tuberculosis infection and lung adenocarcinoma: a case report
We report a case of membranous nephropathy (MN) in a patient with tuberculosis infection and lung adenocarcinoma. A 50-year-old Filipino woman underwent a renal biopsy for the evaluation of proteinuria and hematuria. Immunofluorescence analysis revealed positive staining of IgG in the glomerular basement membrane and mesangial matrices, while electron microscopy demonstrated the presence of sub-epithelial deposits, suggesting MN. To screen for secondary causes of MN, we conducted a computed tomography (CT) scan of the chest and abdomen, which revealed a ground-glass opacity in the middle lobe of the right lung and an enlar...
Source: CEN Case Reports - August 29, 2021 Category: Urology & Nephrology Source Type: research
Nephrotic syndrome with acute kidney injury due to focal segmental glomerulosclerosis following long-term treatment with minodronate
AbstractAlthough bisphosphonates are well known to cause kidney disease, there are very few published cases of focal segmental glomerulosclerosis (FSGS) following treatment with minodronate. Here we report the case of an 86-year-old woman who developed acute kidney injury and nephrotic syndrome after receiving monthly oral minodronate for 24 months. Kidney biopsy revealed cellular variant FSGS. Treatment was initiated with the discontinuation of minodronate followed by intravenous methylprednisolone pulse and prednisolone at 35 mg/day. Subsequently, the patient’s renal function gradually worsened, requiring initiation...
Source: CEN Case Reports - August 28, 2021 Category: Urology & Nephrology Source Type: research
A girl with a mutation of the ciliary gene CC2D2A presenting with FSGS and nephronophthisis
We report a girl with a mutation of the ciliary geneCC2D2A presenting with FSGS and nephronophthisis. The patient had mental retardation, postaxial polydactyly, and ataxic breathing, and was diagnosed as having compound heterozygousCC2D2A missense mutations at age 5. Retrospectively, azotemia at 1 year and proteinuria at 5 years were recorded but not investigated. At age 6, she was referred to the pediatric nephrology service because of hypertension, pretibial pitting edema, heavy proteinuria, and hematuria. eGFR was 66 ml/min/1.73 m2, total protein 5.3 g/dl, albumin 2.4 g/dl, and cholesterol 317 mg/dl. Ultrasonog...
Source: CEN Case Reports - August 25, 2021 Category: Urology & Nephrology Source Type: research
Analysis of water and electrolyte imbalance in a patient with adipsic hypernatremia associated with subfornical organ-targeting antibody
In conclusion, our observations suggested that water and electrolyte imbalance in adipsic hypernatremia is characterized by a certain amount of vasopressin release regardless of serum sodium concentrations with no response to hyperosmolarity . (Source: CEN Case Reports)
Source: CEN Case Reports - August 22, 2021 Category: Urology & Nephrology Source Type: research
Efficacy of renin-angiotensin-aldosterone system blockades for acute phase hypertensive emergencies in patient complicating severe acute kidney injury
AbstractRenin-angiotensin-aldosterone system (RAAS) is primarily involved with pathological mechanism of developing hypertensive emergencies. However, none of clinical practice guidelines mention RAAS blockers for the treatment of hypertensive emergencies. A 44 year-old woman presented with severe hypertension, brain stem posterior reversible encephalopathy syndrome and severe acute kidney injury (AKI). We started anti-hypertensive therapy with continuous intravenous nitroglycerin and oral calcium channel blocker (CCB) and spironolactone. Since severe AK I persisted despite this therapy, we administered losartan potassiu...
Source: CEN Case Reports - August 21, 2021 Category: Urology & Nephrology Source Type: research
Clinicopathological characteristics of kidney injury in non-small cell lung cancer patients under combination therapy including pembrolizumab
We presented four patients, diagnosed with advanced non-small cell lung cancer, who received combination therapy, consisting of pembrolizumab, cisplatin, and pemetrexed as first-line treatment. All of them had been referred to nephrologists and had undergone renal biopsy. We observed that three of four patients presented a very rapid time course for acute kidney injury development. Notably, the three patients received only one or two cycles of the combined chemotherapy. In a renal biopsy, one patient showed severe acute tubular injury rather than interstitial nephritis. Another patient presented focal segmental glomerular ...
Source: CEN Case Reports - August 18, 2021 Category: Urology & Nephrology Source Type: research
Nephritis-associated plasmin receptor (NAPlr)-positive glomerulonephritis in a case of ANCA-negative small vessel vasculitis
AbstractA 75-year-old man with fever was diagnosed with alveolar hemorrhage. Antineutrophil cytoplasmic antibodies for myeloperoxidase and proteinase 3 were absent. He received corticosteroid therapy, which immediately improved his symptoms and chest radiological findings. After the discontinuation of corticosteroids, fever and general fatigue relapsed, and renal function deteriorated with hematuria and proteinuria. A nerve conduction study revealed mononeuritis multiplex. Renal biopsy demonstrated focal necrotizing crescentic glomerulonephritis with endocapillary proliferative lesions, immunofluorescence C3 deposits, and ...
Source: CEN Case Reports - August 13, 2021 Category: Urology & Nephrology Source Type: research
PTRA is useful for renal artery angina by atherosclerotic plaque rupture with unilateral functioning kidney
We report a case of acute ischemic nephropathy in a patient with severe renal artery stenosis and bradycardia due to sick sinus syndrome. An 83-year-old Japanese woman with a history of hypertension was diagnosed with sick sinus syndrome and scheduled for pacemaker implantation. Four days prior to admission for the procedure, she experienced sudden-onset severe right flank pain that persisted for 1 day. On the day of admission, her serum creatinine level increased from 1.35 mg/dL, measured 2 weeks earlier, to 7.04 mg/dL. Laboratory examinations showed elevated C-reactive pr otein and lactate dehydrogenase levels. A co...
Source: CEN Case Reports - August 11, 2021 Category: Urology & Nephrology Source Type: research
Clinical effect of rabbit anti-thymocyte globulin for chronic active antibody-mediated rejection after kidney transplantation
In conclusion, this report describes the case of a ki dney transplant recipient who developed CAAMR, treated using rabbit anti-thymocyte globulin. This strategy might be a viable treatment option for CAAMR after a kidney transplant. (Source: CEN Case Reports)
Source: CEN Case Reports - August 10, 2021 Category: Urology & Nephrology Source Type: research
An extremely mild clinical course in a case with LAMB2-associated nephritis diagnosed with next-generation sequencing
We report a patient withLAMB2-associated renal disorder showing an extremely mild phenotype. A 5-year-old girl presented with asymptomatic proteinuria and hematuria detected by urinalysis screening. She had been previously healthy without any additional renal symptoms. The serum albumin and creatinine levels were normal. Renal biopsy revealed minor glomerular abnormalities with occasional focal mesangial proliferation. Electron microscopy showed no structural changes in the glomerular basement membrane. Targeted sequencing of podocyte-related genes using next-generation sequencing was performed. As a result, previously rep...
Source: CEN Case Reports - July 9, 2021 Category: Urology & Nephrology Source Type: research
Pneumonia and central nervous system infection caused by reactivation of varicella-zoster virus in a living-donor kidney transplantation patient: case report and review of the literature
AbstractVaricella-zoster virus (VZV) typically causes herpes zoster in the elderly due to reactivation, but immunocompromised individuals may develop organ damage such as pneumonia with a poor prognosis. We herein report a case of pneumonia and central nervous system (CNS) infection caused by reactivation of VZV in a 50-year-old man who had received a living-donor kidney transplant. We also conducted a literature review of adult cases with pneumonia or CNS infection caused by VZV after kidney transplantation. It showed that there are cases in which eruptions appeared upto 21 days after the onset of the disease and others...
Source: CEN Case Reports - July 9, 2021 Category: Urology & Nephrology Source Type: research
Amiodarone-induced multiple organ damage in an Alstr öm syndrome patient with end-stage renal disease and hepatic cirrhosis
AbstractAlstr öm syndrome (AS) is an extremely rare disease accompanied by blindness, hearing loss, obesity, type 2 diabetes, dilated cardiomyopathy, and progressive hepatic and renal dysfunction. The life span of AS patients rarely exceeds 50 years, and thus there are very few reports describing the implementa tion of renal replacement therapy for these patients. We here report a case of AS patient who exhibited dilated cardiomyopathy, end-stage renal disease, and hepatic cirrhosis. He underwent hemodialysis therapy more than 3 years. Although he eventually died of amiodarone-induced multiple organ damag e in the lungs...
Source: CEN Case Reports - July 5, 2021 Category: Urology & Nephrology Source Type: research
Point of care cardiac ultrasound in the management of hyponatremia: an enhancement to physical examination
AbstractAccurate assessment of fluid status is vital to appropriate management of hyponatremia. However, conventional parameters such as physical examination, vital signs, and laboratory markers such as natriuretic peptides suffer from limitations in this regard. Point of care ultrasonography (POCUS) is a noninvasive bedside diagnostic tool that is emerging as an adjunct to physical examination in internal medicine and subspecialties including nephrology. In this manuscript, we describe a complex case of hyponatremia, where stroke volume assessment using Doppler echocardiography has helped to objectively assess fluid statu...
Source: CEN Case Reports - July 5, 2021 Category: Urology & Nephrology Source Type: research
