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A Case of Aneurysm Induced Obstructive Nephropathy Masked

机译:掩盖动脉瘤性梗阻性肾病1例

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Although rare, obstructive nephropathy secondary to iliac artery aneurysms have been reported to occur. We describe a case of a patient admitted for non-cardiac chest pain and found to be in non-oligoanuric acute renal failure. A renal ultrasound revealed aortic and bilateral iliac aneurysms with minimal evidence of hydronephrosis. Clinically, the patient had a normal to high urine output requiring continuous volume repletion. Urine studies repeatedly showed low osmolarity without other derangements. Only after progressive deterioration of renal function did obstruction surface as a plausible etiology Bilateral ureteral stent placement and subsequent resolution of renal failure eventually confirmed the diagnosis of obstructive uropathy. This presentation illustrates a case of bilateral ureteral obstruction and obstructive nephropathy that was masked by high urinary output from water diuresis likely due to nephrogenic diabetes insipidus (DI). The DI masked the clinical signs of obstruction, specifically oligoanuria.
机译:尽管很少见,但据报道会发生继发于artery动脉瘤的阻塞性肾病。我们描述了一个因非心脏性胸痛入院并发现患有非少尿性急性肾功能衰竭的患者的病例。肾脏超声检查显示主动脉和双侧动脉瘤,几乎没有肾积水的证据。临床上,患者尿量正常至较高,需要连续补充体积。尿液研究反复显示渗透压低,没有其他紊乱。只有在肾功能进行性恶化后才将阻塞表面作为合理的病因。双侧输尿管支架置入和随后肾功能衰竭的解决最终证实了阻塞性尿路病的诊断。本演讲介绍了双侧输尿管梗阻和梗阻性肾病的病例,该病被水利尿导致的高尿量掩盖,这很可能是由于肾原性尿崩症(DI)引起的。 DI掩盖了阻塞的临床体征,特别是少尿尿。

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