Non-dilated obstructed pelvicalyceal system

Kulkarni, S.; Jayachandran, Maanasa; Davies, Anthony; Mamoun, W; Al-Akraa, Mahmoud

doi:10.1111/j.1368-5031.2005.00507.x

Cited by 6 publications

(3 citation statements)

References 4 publications

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“…If hypoperfusion is suspected, the response to a fluid bolus should be assessed. Ultrasonography can diagnose most causes of obstruction, although occasionally an obstructed urinary tract is not dilated . Intra‐abdominal pressure can be raised by ascites, blood, fluid overload, oedematous bowel, and intra‐abdominal sepsis .…”

Section: Preventing Peri‐operative Renal Dysfunctionmentioning

confidence: 99%

Peri‐operative renal dysfunction: prevention and management

2015

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Summary Postoperative increases in serum creatinine concentration, by amounts historically viewed as trivial, are associated with increased morbidity and mortality. Acute kidney injury is common, affecting one in five patients admitted with acute medical disease and up to four in five patients admitted to intensive care, of whom one in two have had operations. This review is focused principally on the identification of patients at risk of acute kidney injury and the prevention of injury. In the main, there are no interventions that directly treat the damaged kidney. The management of acute kidney injury is based on correction of dehydration, hypotension, and urinary tract obstruction, stopping nephrotoxic drugs, giving antibiotics for bacterial infection, and commencing renal replacement therapy if necessary.

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Section: Preventing Peri‐operative Renal Dysfunctionmentioning

confidence: 99%

Peri‐operative renal dysfunction: prevention and management

2015

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“…Complete anuria suggests renal tract obstruction and is otherwise unusual in acute renal failure. Renal ultrasonography is the preferred method to detect dilatation of the renal pelvis and calyces, although obstruction may be present without dilatation,17 particularly in malignancy.…”

Section: How Do I Assess a Patient With Acute Renal Failure?mentioning

confidence: 99%

Acute renal failure

Hilton

2006

BMJ

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“…Renal ultrasonography has a high negative predictive value in ruling out urinary obstruction [ 2 ]; nevertheless, there have been several cases of NDOU in the literature, which represent 4–5% of obstructive uropathy, indicating the importance of retaining a high index of suspicion for postrenal etiologies despite the nonsignificant pelvic-ureteric dilatation found on ultrasound. Moreover, the majority of NDOU cases reviewed in the literature were secondary to malignant obstruction [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Thinking Beyond Acute Kidney Injury

El-Alali

Moreno

Jaber

2022

Case Rep Nephrol Dial

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Acute kidney injury (AKI) can be a significant clue to solving a puzzling patient presentation. Postrenal AKI should be suspected if imaging shows any degree of hydronephrosis and can be caused by a variety of conditions. Diagnosis of urinary obstruction without significant dilatation of the pelvic-ureteral system requires a higher degree of suspicion, and hence, its identification can become late. In patients without prior cancer screening, the etiology of obstructive uropathy must be broadened to include primary or metastatic malignancy. Clinicians should look beyond the AKI to properly evaluate the etiology of the patient’s presentation and symptoms. In this report, we present the case of a middle-aged female with no known past medical history who presented with AKI secondary to malignant retroperitoneal fibrosis as the first manifestation of metastatic breast cancer. Her AKI was associated with acute onset anuria and was found to have nondilated postrenal AKI with no significant abnormalities on renal imaging. Early onset anuria in the setting of AKI, which persists despite fluid resuscitation, can suggest complete urinary tract obstruction even with reassuring results of initial renal images, and in the patient with no history of cancer screening, malignancy should be suspected as a primary cause of obstructive uropathy.

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Non-dilated obstructed pelvicalyceal system

Cited by 6 publications

References 4 publications

Peri‐operative renal dysfunction: prevention and management

Peri‐operative renal dysfunction: prevention and management

Acute renal failure

Thinking Beyond Acute Kidney Injury

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