Bilateral transarterial nephrectomy in a case of autosomal dominant polycystic kidney disease

9^th International Conference on Dialysis and Renal Care

August 18-19, 2016 London, UK

Dorin Dragos, L Damian, D Ionescu and A Bucur

Carol Davila University of Medicine and Pharmacy, Romania
Bucharest Emergency University Hospital, Romania

Posters & Accepted Abstracts: J Nephrol Ther

Abstract :

Chronic kidney disease, urinary tract infections, nephrolithiasis and hematuria are common renal complications of autosomal dominant polycystic kidney disease (ADPKD). Although rarely used in ADPKD, transcatheter arterial embolization has among its indications persis-tent, debilitating or life threatening hemorrhage. This is the case of a 44 years old female that presented at the emergency room with frank hematuria and asthenia. Her family history and grossly enlarged kidneys with multiple cysts on ultrasound suggested ADPKD complicated with hematuria and chronic kidney disease. Cystoscopy showed blood coming from both ure-ters at a higher rate from the left one. A 1.5 g/dl drop in the hemoglobin concentration in 48 hours associated with marked symptomatology led to the decision to embolize the left renal artery, especially since the renal function was already severely compromised. Hematuria per-sists with worsening anemia and severe renal dysfunction, forcing the initiation of hemodial-ysis and right renal artery embolization. Bilateral transarterial nephrectomy was later compli-cated by a post-infarction syndrome with significant leukocytosis, fever and severe lumbar pain remitted under conservative treatment. An interesting feature was the presence of ne-phrotic range proteinuria (20 g/24 h), uncharacteristic for ADPKD. The evolution was favor-able with remission of the inflammatory syndrome and continuation of hemodialysis without further complications. We can conclude that, although unusual in ADPKD and having known specific complications, transarterial nephrectomy can be successfully used in this pathology when there is a life threatening non-self-limited kidney hemorrhage, especially in the setting of significant/advanced renal insufficiency.

Biography :

Email: alina_medcon@yahoo.com