Your browser doesn't support javascript.
loading
Acute Kidney Injury in a Previously Healthy 56-Year-Old Male Following a Direct Visual Internal Urethrotomy of a Bulbar Stricture.
Calenda, Charles D; Toohey, Cameron R; Levy, Madeline; Vanmali, Nisha; Ubhi, Jaspreet; Ishak, Noshi; Marshall, Stephen D.
Afiliación
  • Calenda CD; College of Osteopathic Medicine, University of New England, Biddeford, USA.
  • Toohey CR; College of Osteopathic Medicine, University of New England, Biddeford, USA.
  • Levy M; College of Osteopathic Medicine, University of New England, Biddeford, USA.
  • Vanmali N; Department of Internal Medicine, Concord Hospital - Laconia, Laconia, USA.
  • Ubhi J; Department of Internal Medicine, Concord Hospital - Laconia, Laconia, USA.
  • Ishak N; Department of Nephrology, Concord Hospital - Laconia, Laconia, USA.
  • Marshall SD; Department of Urology, Concord Hospital - Laconia, Laconia, USA.
Cureus ; 16(4): e59310, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38817513
ABSTRACT
Acute kidney injury (AKI) is a frequent finding in acutely ill and hospitalized patients arising from various etiologies. Anuric AKI, a more pronounced form of AKI in which less than 100 cc of urine is produced per day, is most frequently encountered in hospitalized, septic, and post-surgical patients, often secondary to shock or bilateral urinary tract obstruction. The development of anuric AKI in previously healthy patients after outpatient urological procedures presents a unique challenge to physicians, as many outpatient procedures require the routine perioperative administration of multiple nephrotoxic medications. Further complicating this clinical scenario, some surgical procedures that intrinsically involve iatrogenic injury to the kidney, ureter, bladder, or nearby organ can rarely lead to a phenomenon known as reflex anuria, an anuric state typically associated with AKI. Here, we report an unusual case of a previously healthy 56-year-old male who developed anuric AKI two days after direct visual internal urethrotomy (DVIU) for the treatment of a bulbar stricture. Non-contrast CT revealed no signs of an obstructive process, and laboratory findings supported an intrarenal cause of AKI. Consideration was given to non-steroidal anti-inflammatory drugs (NSAID)-induced nephrotoxicity, gentamicin-associated acute tubular necrosis, and propofol infusion syndrome, in addition to their potential synergistic effects. We also explore this as the first reported case of reflex anuria occurring at the level of the bulbar urethra, as most cases have involved direct injury to the kidney or ureter. Over the course of 10 days, our patient responded well to treatment with supportive measures and dialysis, with his vomiting, electrolyte abnormalities, renal state, and anuria eventually improving.
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cureus Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cureus Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos
...