Oliguric glomerulonephritis and parathyroid adenoma

Abstract

SummaryThe case is reported of a woman who recovered from acute glomerulonephritis with oliguria of 43 days duration and who subsequently developed hypercalcaemia, treated by parathyroidectomy.The evidence is presented that the acute nephritis developed in the presence of a primary parathyroid adenoma, providing the natural experiment of hypercalcaemia temporarily depressed by acute renal failure. IntroductionThe gloomy prognosis of acute oliguric glomerulonephritis (Berlyne & Baker, 1964) is relieved by occasional reports of recovery following prolonged oliguria (Persoff, 1965). Here we report recovery from acute glomerulonephritis after 43 days of oliguria and discuss the implications of renal biopsy findings in such patients, and their management by dialysis, diet and drugs.Our patient also had a parathyroid adenoma, later successfully removed. The report illustrates the effect of acute renal failure on the biochemistry of hyperparathyroidism and the difficulty of distinguishing primary from secondary hyperparathyroidism.