Polycythemia in a Patient With Atonic Bladder and Hydronephrosis

Abstract

Kidneys influence the production of red blood cells by secreting most of the erythropoietin (EPO) in adults. Consequently, renal diseases often impact erythropoiesis and hemoglobin levels. Chronic kidney diseases lead to anemia due to EPO deficiency. However, erythrocytosis can occur in patients with cystic diseases of the kidney and renal artery stenosis due to upregulation of hypoxia-inducible factors (HIFs) and increased EPO production. Here, we present a patient with secondary polycythemia who was found to have atonic bladder and hydronephrosis. Resolution of hydronephrosis led to the reversal of erythrocytosis, highlighting the intricate regulation of red cell production.

A giant hydronephrosis disguised as abdominal obesity

“…Clinical symptoms may include vague abdominal distension, hematuria, abdominal pain, recurrent urinary tract infection, secondary hypertension, and renal failure. The pressure on the renal tubules can lead to intrarenal ischemia, which may result in secondary polycythemia 1,2 …”

“…The pressure on the renal tubules can lead to intrarenal ischemia, which may result in secondary polycythemia. 1,2 It is important to consider fat, fluid, feces, fetus, and flatus (5 F's) while evaluating abdominal distension. This case highlights the importance of a thorough clinical examination and a low threshold for imaging while evaluating causes of abdominal distension other than obesity.…”

“…The pressure on the renal tubules can lead to intrarenal ischemia, which may result in secondary polycythemia. 1 , 2 …”