Listen to my kidney!

Cokkinos, Philip; Doulaptsis, Constantinos; Chrissos, Dimitrios N.; Zarmakoupis, Constantinos; Voudris, Vassilis

doi:10.1016/s0140-6736(09)61524-5

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…The primary presenting sign is gross hematuria, but high-output heart failure and hypertension also may be seen. 2 The latter is presumably due to activation of the renin-angiotensin system resulting from ischemia distal to the AVM. 3 …”

Section: Discussionmentioning

confidence: 99%

Primary arteriocalicial fistula: A dangerously rare cause of hematuria

Cabello

Miguelañez

Abad

et al. 2018

Urology Case Reports

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Section: Discussionmentioning

confidence: 99%

Primary arteriocalicial fistula: A dangerously rare cause of hematuria

Cabello

Miguelañez

Abad

et al. 2018

Urology Case Reports

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“…Patients usually present with hypertension and hematuria [3]. Etiologies include congenital, trauma, malignancies, surgery and percutaneous kidney biopsies [1,3] Treatment and management include transcatheter coil embolization, surgical resection, or a combination of the two for definitive treatment [3]. Embolization is generally preferred in patients with only one functioning kidney and in poor surgical candidates [2,4].…”

Section: Discussionmentioning

confidence: 99%

“…Renal arteriovenous (AV) fistulas and malformations are rare in nature with a prevalence of 0.4% [1]. They are commonly associated with traumatic injuries (50-80%) and degenerative changes or inflammation [2].…”

Section: Introductionmentioning

confidence: 99%

Nontraumatic Renal Arteriovenous Fistula

Kompelli¹,

Zabaneh²,

Zabaneh³

et al. 2016

J Kidney

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“…Renal arteriovenous fistulae have an estimated prevalence of <0.04%, 10,11 and represent between 14% and 53% of all arteriovenous abnormalities. 12 Fistulae can be acquired or congenital. Approximately 70% of renal arteriovenous fistulae are acquired, with the remaining 30% thought to be congenital.…”

Section: Discussionmentioning

confidence: 99%

“…15 Ultrasonography, renal computed tomography, and magnetic resonance angiography are the diagnostic procedures of choice. 12 Treatment options for symptomatic renal arteriovenous fistulae include surgical ligation with or without partial or total nephrectomy, 10 or percutaneous transcatheter embolization. Transcatheter embolization of a renal arteriovenous fistula was first described in 1973.…”

Section: Discussionmentioning

confidence: 99%

The Thrill Is Gone

2015

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Foreword Information about a real patient is presented in stages (boldface type) to expert clinicians (Drs Beckman and Sobieszczyk), who respond to the information, sharing his reasoning with the reader (regular type). A discussion by the authors follows.A n 85-year-old white woman with longstanding atrial fibrillation and hypertension presented to our emergency department with a 2-day history of progressive dyspnea. Earlier that week she had been seen by an outpatient provider and was found to be hypotensive. Her home bumetanide was discontinued, and she developed dyspnea that progressed after missing 2 doses. She reported that she was sleeping with more pillows and that she had a limited ability to walk and a new cough.Her recent history was notable for progressive fatigue and dyspnea over the past year. In the past 3 months she had been treated as an outpatient with loop diuretics for presumed congestive heart failure by a cardiologist. Her recent history was also notable for recurrent hematochezia requiring 5 admissions, including an intensive care unit admission for hemorrhagic shock, over the preceding 6 months. An extensive evaluation, including esophagastroduodenoscopy, several colonoscopies, and a small-intestine capsule study were unrevealing; she was noted only to have severe diverticulosis. During this period, her warfarin and, after additional bleeding episodes, her aspirin were stopped in light of her recurrent bleeding.Additional medical history included a diagnosis of cataracts, macular degeneration, and osteoarthritis. Medications included bumetanide 1 mg daily, metoprolol succinate 50 mg daily, omeprazole 40 mg daily, and calcium supplements. She had no known drug allergies.Dr Beckman: Dyspnea in an older patient is a common concern and is predominantly caused by a range of cardiopulmonary diseases. In this case, the patient's presentation is notable for progressive dyspnea over 1 year that has acutely worsened over several days. Her report of orthopnea, cough, and exertional intolerance suggest that an exacerbation of congestive heart failure is likely. Moreover, her diagnosis of congestive heart failure is only presumed, and further investigation is needed to understand this acute presentation. Other etiologies of progressive dyspnea include anemia related to her recent gastrointestinal bleeding, or a primary pulmonary process such as interstitial lung disease, chronic obstructive pulmonary disease, malignancy, pulmonary hypertension, or an infectious process such as a viral respiratory infection or pneumonia. Patient presentation (continued):Initial vital signs on presentation included an oral temperature of 95°F, a heart rate of 81 beats per minute, blood pressure of 110/56 mm Hg, respiratory rate of 20 breaths per minute, oxygen saturation of 85% on room air with improvement to 95% on 3 L nasal cannula oxygen supplementation. Physical examination was notable for a cachectic-appearing woman in no acute distress. Her neck examination revealed marked internal jugular venous engorgement with v...

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Listen to my kidney!

Cited by 7 publications

References 5 publications

Primary arteriocalicial fistula: A dangerously rare cause of hematuria

Primary arteriocalicial fistula: A dangerously rare cause of hematuria

Nontraumatic Renal Arteriovenous Fistula

The Thrill Is Gone

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