Acute Renal Failure in Adults with Uncomplicated Acute Pyelonephritis: Case Reports and Review

Jones, Stephen R.

doi:10.1093/clinids/14.1.243

Cited by 19 publications

(9 citation statements)

References 14 publications

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“…In addition, he was not clinically septic and had a normal platelet count. Although pyelonephritis is an unusual cause of acute renal failure [4][5][6], acute pyelonephritis was the apparent cause of acute renal failure in this case. It may be argued that infection-associated allograft dysfunction is much more likely to be the result of an acute rejection episode, probably due to the enhanced cytokine-induced expression of class II histocompatibility antigens.…”

Section: Discussionmentioning

confidence: 59%

Acute Focal Bacterial Nephritis Presented as Acute Renal Failure and Hepatic Dysfunction in a Renal Transplant Recipient

Yang¹,

Kim²,

Yang

et al. 1994

Am J Nephrol

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We describe acute focal bacterial nephritis (AFBN) presented as acute renal failure and hepatic dysfunction in a renal transplant recipient. He had received a renal transplantation 5 years previously and maintained good renal function without an episode of acute rejection or any urinary abnormalities. He had been an HBsAg carrier and showed mild elevation of liver enzymes after renal transplantation. For 5 days before admission, the patient suffered from fever, graft kidney swelling, tenderness and oliguria. On admission, renal biopsy was performed and solumedrol pulse therapy was started under the impression of acute rejection. The following laboratory findings revealed acute renal failure and hepatic dysfunction. From the abdomen CT and renal biopsy findings this case was confirmed as AFBN in a grafted kidney. With successive hemodialysis and antibiotic therapy clinical symptoms and renal function improved promptly. In acute hepatic dysfunction we discontinued cyclosporine (CsA) to prevent irreversible fulminant hepatic failure until the normalization of liver function. It should be considered that AFBN must be included in the differential diagnosis of acute rejection, and the early diagnosis and treatment of AFBN is important to save the grafted kidney. In addition, early withdrawal of CsA is essential to prevent irreversible hepatic failure when infection triggers hepatic dysfunction in HBsAg-positive renal transplant recipients.

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Section: Discussionmentioning

confidence: 59%

Acute Focal Bacterial Nephritis Presented as Acute Renal Failure and Hepatic Dysfunction in a Renal Transplant Recipient

Yang¹,

Kim²,

Yang

et al. 1994

Am J Nephrol

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“…Prompt diagnosis with antibiotic coverage had a favorable effect on the prognosis of pyelonephritis-induced acute kidney injury in most of the patients. However, three died from pyelonephritis and two required hemodialysis [9][10][11][12][13][14][15][16][17][18][19]. A severe form of pyelonephritis, emphysematous pyelonephritis, is characterized by gas within the renal parenchyma and/or the collecting ducts.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury from pyelonephritis in an elderly man: case report

et al. 2011

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Pyelonephritis is rarely considered in the differential diagnosis of acute kidney injury. Acute non-obstructed bacterial pyelonephritis is an infrequent and rarely considered cause of rapidly progressive acute kidney injury. A diagnostic challenge thus develops as it is difficult to clinically differentiate acute kidney injury secondary to ischemic or toxic acute tubular necrosis or papillary necrosis versus acute interstitial nephritis secondary to drugs or infectious pyelonephritis. We describe a case of acute kidney injury due to suppurative pyelonephritis in an elderly immunocompetent man who presented with dysuria, vomiting, and fever and later found to have histologic and radiologic proven pyelonephritis as the cause of acute kidney injury in the absence of hypotension, nephrotoxic agents, non-steroidal analgesics, immunosuppression, urinary tract obstruction, or other structural anomalies. The patient was managed with antimicrobial therapy, hemodialysis, and a short course of corticosteroids.

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“…The infec tive organism almost always has been Escherichia coli. the patients were often treated by nonsteroidal anti-inflammatory agents and frequently presented with fever or symptoms of urinary tract infection [2], The exceptionally asymptomatic presenta tion in our patient may reflect a reaction to an indolent infection by a rather rare patho gen of the urinary tract [3], Thus, intrarenal low-grade infection may be under-recog nized as a cause for rapid deterioration of kidney function [4] and, as illustrated by this case, should be suspected even in the ab sence of fever or relevant complaints, espe cially in the elderly [2,5] …”

Section: Amoxicillinmentioning

confidence: 99%

Asymptomatic Group-B Streptococcal Pyelonephritis: An Unusual Cause of Acute Renal Failure

Heyman¹,

Brezis²

1997

Nephron

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Acute Renal Failure in Adults with Uncomplicated Acute Pyelonephritis: Case Reports and Review

Cited by 19 publications

References 14 publications

Acute Focal Bacterial Nephritis Presented as Acute Renal Failure and Hepatic Dysfunction in a Renal Transplant Recipient

Acute Focal Bacterial Nephritis Presented as Acute Renal Failure and Hepatic Dysfunction in a Renal Transplant Recipient

Acute kidney injury from pyelonephritis in an elderly man: case report

Asymptomatic Group-B Streptococcal Pyelonephritis: An Unusual Cause of Acute Renal Failure

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