RESUMO
Primary membranous nephropathy is typically a disease of middle-aged white men but should be included in the differential diagnosis of nephrotic syndrome in patients of any age and race. Serological anti-PLA2R testing must be interpreted in the appropriate clinical context and histological PLA2R staining is recommended in seronegative patients.
RESUMO
Though IgA nephropathy is relatively uncommon in African Americans, our case serves as a reminder that it needs to be considered in the differentials when these patients present with proliferative glomerulonephritis.
Assuntos
Acidose Tubular Renal/induzido quimicamente , Glicemia/efeitos dos fármacos , Canagliflozina/efeitos adversos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Síndrome de Fanconi/induzido quimicamente , Inibidores do Transportador 2 de Sódio-Glicose/efeitos adversos , Acidose Tubular Renal/diagnóstico , Biomarcadores/sangue , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Cetoacidose Diabética/induzido quimicamente , Substituição de Medicamentos , Síndrome de Fanconi/diagnóstico , Feminino , Humanos , Insulina/uso terapêutico , Pessoa de Meia-Idade , Resultado do TratamentoAssuntos
Cistite/diagnóstico por imagem , Cistite/microbiologia , Transplante de Rim , Infecções por Klebsiella/diagnóstico por imagem , Transplante de Pâncreas , Antibacterianos/uso terapêutico , Cistoscopia , Diagnóstico Diferencial , Disuria , Hematúria , Humanos , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
Urinary tract obstruction leading to acute kidney injury is usually associated with bilateral hydroureters and hydronephrosis, often accompanied by oliguria. We present an atypical case of obstructive uropathy without these features that presented with severe acute kidney injury. A 64-year-old male with no known medical history has presented with a 2-week history of nausea, decreased appetite, flank pain, and lower extremity edema, and was found to have an elevated creatinine of 10.5 mg/dL. Renal ultrasound showed mild prominence of the bilateral renal collecting systems with no evidence of hydronephrosis. Computed tomography scan showed findings suggestive of retroperitoneal fibrosis involving ureteral region and bilateral ureteral stent placement has led to dramatic improvement of creatinine to 1.3 mg/dL over the next 4 days.
