Organophosphate intoxication is a very infrequent cause of acute deterioration of renal function but, when it does occur, it seriously aggravates the clinical status and prognosis. The pathogenesis of renal injury in this context remains unknown, although it is suspected that direct damage occurs at renal tubules. It has not been demonstrated that substitutive kidney treatment and specific antidotes provide any clear benefit. Here, we report a 58-year-old patient who underwent an accidental organophosphate intoxication, who suffered acute anuric renal failure and severe metabolic acidosis and who was successfully treated with conventional haemodialysis. The patient recovered with no sequellae and no need for other therapeutic measures.

Bartter syndrome can manifest in three different forms and is rarely concomitant with glomerular nephropathies. However, this association is more frequently observed in children. We report the case of a 50-year-old woman with Gitelman syndrome for the past 30 years who also had a nephrotic syndrome of recent appearance. Her renal biopsy revealed hyperplasia of the juxtaglomerular apparatus and mesangial deposits of C1q, with no clinical or serological evidence of systemic erythematous lupus. We have not found any reports of instances of association of Gitelman syndrome and nephrotic syndrome arising from C1q nephropathy in adult patients. Our case suggests the possible existence of an association between hypokalaemic tubular nephropathies and glomerular nephropathies that may cause nephrotic syndrome.

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The axillary-femoral bypass is an extra-anatomical arterial reconstruction technique whose indications and complications have been thoroughly discussed in the literature. Shortening or lengthening of the prosthesis (by axillary artery traction or graft angulation, respectively) as a late postoperative complication of the procedure has been described only exceptionally. Here we report a kinking of the prosthesis with a very illustrative figure.