Pseudo-acute Renal Failure due to Intraperitoneal Urine Leakage

Zhou, Changyu; Ying, Xuxia; Feng, Weisheng

doi:10.2169/internalmedicine.54.3330

Cited by 9 publications

(18 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This leakage may result in perirenal extravasation and eventually urinary ascites. Sometimes this situation presents as renal pseudo-failure (laboratory abnormalities of acute kidney injury in the setting of normal kidney function) [18][19][20]. In our case severe obstruction secondary to kidney stone and high intrarenal pressure may be causing perirenal urine extravasation.…”

Section: Discussionmentioning

confidence: 76%

Regression of Renal Failure after Unilateral Simple Nephrectomy

Eskidemir¹,

Turna²

2018

JCR

View full text Add to dashboard Cite

Background: Chronic kidney disease is widely recognized as a significant public health concern. Kidney stones are infrequently implicated as the primary cause of end-stage renal disease. Case Report: We report a case of chronic kidney disease and concomitant unilateral kidney stone with ipsilateral non-functioning kidney which surprisingly regresses after unilateral simple nephrectomy. Conclusion: Removal of the non-functioning hydronephrotic kidney with kidney stone should be kept in mind in the presence of renal failure.

show abstract

Section: Discussionmentioning

confidence: 76%

Regression of Renal Failure after Unilateral Simple Nephrectomy

Eskidemir¹,

Turna²

2018

JCR

View full text Add to dashboard Cite

show abstract

“…1 The new onset of renal failure in such clinical cases is based on the concept of "reverse auto-dialysis" of the peritoneal membrane, a reverse form of continuous peritoneal dialysis that is most apparent when the presentation is delayed. 2 The expression 'reverse peritoneal dialysis' was first used in 1991. 3 It is characterized by a flux of small molecules such as creatinine and urea from urine collected in the peritoneum along a concentration gradient opposite to conventional peritoneal dialysis where small molecules move from the blood to peritoneal cavity.…”

Section: Discussionmentioning

confidence: 99%

“…20 Clinicians should distinguish pseudo renal failure from true renal failure based on laboratory analysis of peritoneal fluid, which has higher levels of urea, creatinine, and potassium than serum. [1][2][3][4][5][6][7][8][9][10] Emergency management of these patients depend on the clinical scenario. Unfortunately, most of these patients are elderly and are moribund at presentation, thereby precluding any major definitive surgery like a radical cystectomy.…”

Section: Discussionmentioning

confidence: 99%

“…However, sometimes this exact presentation can be mimicked in patients who have intraperitoneal leakage of urine and undergo absorption of creatine into the blood stream through a process of reveres auto-dialysis, being called pseudo renal failure. 1 , 2 This rare clinical presentation has been reported in cases of bladder carcinoma following intraperitoneal perforation due to extensive malignant permeation of the wall. 3 Herein, we report the case of a patient with squamous cell carcinoma of the urinary bladder who presented acutely with rapid onset of abdominal distension with markedly elevated, creatinine which was later proven to be pseudo renal failure caused by extravasation from acute unilateral ureteric obstruction.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An interesting presentation of invasive bladder carcinoma as pseudo renal failure

et al. 2022

View full text Add to dashboard Cite

Ascites and oliguria with an increasing serum creatinine level are often observed in patients with acute renal failure. However, these symptoms are also noted in individuals with intraperitoneal urinary leakage and can be mistaken for acute renal failure. This rise in creatinine in such patients is called pseudo renal failure and it happens by a process of reverse peritoneal dialysis. In literature, the most commonly described condition that leads to this clinical picture is following a spontaneous or missed bladder perforation. We, herein, report a case of carcinoma of the bladder that presented with features resembling acute renal failure, which later turned out to be pseudo renal failure due to intraperitoneal urinary extravasation from a forniceal rupture. The patient was managed with emergency with a percutaneous drain followed by a percutaneous nephrostomy, which led to normalization of creatinine. Cystoscopy revealed the bladder growth in an intact small capacity bladder and biopsy confirmed it as a muscle invasive squamous cell carcinoma. Due to advanced nature of his malignancy, he underwent a palliative ileal conduit diversion but he later developed chest metastasis and ultimately succumbed to the disease. Intraperitoneal urinary leakage due to forniceal rupture presenting as pseudo renal failure is a rare presentation of carcinoma bladder. Sudden onset abdominal discomfort, increasing ascites, hematuria, and oliguria with elevated renal parameters needs consideration and exclusion of this entity. The diagnostic dilemma associated with this rare presentation along with the management and prognosis in such patients of carcinoma bladder are discussed.

show abstract

“…[ 4 ] The elevation of serum creatinine is secondary to the absorption of urine across the peritoneal membrane and is a known mimicker of presentations of acute renal failure. [ 5 6 ] A CT examination is the most common tool in the diagnosis of bladder rupture. [ 7 ] Renal scintigraphy is not the first-line imaging modality in the diagnosis of bladder rupture; however, with unexplained laboratory values and symptoms within a postoperative patient, renal scintigraphy can play a pivotal role; postvoid and delayed phase imaging, in particular, can demonstrate sequela of a bladder rupture as well as other sequela of postsurgical complications with damage to the collecting system.…”

Section: Discussionmentioning

confidence: 99%