Retroperitoneal Fibrosis: A Rare Cause of Acute Renal Failure

Abstract

Introduction. Retroperitoneal fibrosis is a rare cause of acute renal failure (ARF) with only a handful of cases reported in literature. We report a case of a 40-year-old male with an incidental finding of retroperitoneal fibrosis. Case Presentation. Patient is a 40-year-old African American male with no significant past medical history who presented with a four-month history of low back pain and associated nausea with vomiting. Physical examination was significant for elevated blood pressure at 169/107 mmhg and bilateral pedal edema. Significant admission laboratory include blood urea nitrogen (BUN) of 108 mg/dL, serum creatinine (Cr) of 23 mg/dL, bicarbonate of 19 mg/dL, and potassium of 6.2 mmL/L. Renal ultrasound showed bilateral hydronephrosis. Post-void residual urine volume was normal. Abdominopelvic CT scan showed retroperitoneal fibrosis confirmed with fine-needle biopsy. He was treated with a combination of bilateral ureteral stent placement, hemodialysis, and steroid therapy. Four months after hospital discharge, his BUN and Cr levels Improved to 18 mg/dL and 1.25 mg/dL, respectively. Conclusion. Retroperitoneal fibrosis should be considered as a differential diagnosis in patients with acute renal failure and obstructive uropathy. Abdominal CT scan is the examination of choice for diagnosis. Full resolution with treatment depends on the duration of obstruction.

Retroperitoneal Fibrosis Due to Opium Abuse: A Case Series and Literature Review

“…RPF is a rare condition with a prevalence of 11.4/100,000 individuals and an incidence of 0.1/100,000 per year (2). RPF has an unclear etiology, and was first described by Albarron in 1905 (1, 2).…”

“…RPF has an unclear etiology, and was first described by Albarron in 1905 (1, 2). However, more cases of this disease have since been reported (1, 7, 8).…”

“…It was first described in 1905, but more cases of this disease have since been reported (1, 2). RPF presents with the development of aberrant fibroinflammatory tissue in the retroperitoneal space, which can lead to entrapment and obstruction of the retroperitoneal structures, such as the ureters, aorta, and other abdominal organs (1, 3).…”

“…In primary RPF, the specific cause of disease is unknown, while in the secondary type, other factors, such as infection, neoplasm, trauma, surgery, radiotherapy, and certain drugs are the underlying factors that lead to the formation of RPF (2-4). …”

“…It can also present with ureteral obstruction, lower extremity edema, varicocele, and renal failure (1, 2, 6). …”