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post obstructive diuresis

Stewart W Shankel
BACKGROUND The purpose of presenting this case is to demonstrate the degree to which the kidney is capable of selectively excreting a massive load of sodium and water when challenged with both of these, without altering the plasma levels of other ions. CASE REPORT An 8-year-old boy was admitted in severe renal failure. Workup demonstrated a high grade obstruction of a single kidney. Following dialysis, the patient underwent surgery to correct the obstruction and he developed post-obstructive diuresis. Within one week he was receiving 34 liters of essentially 1/2 Na by IV and by mouth and was excreting 70% of his filtered load of water and 50% of his filtered load of sodium...
January 16, 2018: American Journal of Case Reports
Emily S Blum, Antonio R Porras, Elijah Biggs, Pooneh R Tabrizi, Rachael D Sussman, Bruce M Sprague, Eglal Shalaby-Rana, Massoud Majd, Hans G Pohl, Marius George Linguraru
PURPOSE: We sought to define features that describe the dynamic information in diuresis renograms for the early detection of clinically significant hydronephrosis caused by ureteropelvic junction obstruction. MATERIALS AND METHODS: We studied the diuresis renogram of 55 patients with a mean ± SD age of 75 ± 66 days who had congenital hydronephrosis at initial presentation. Five patients had bilaterally affected kidneys for a total of 60 diuresis renograms. Surgery was performed on 35 kidneys...
October 21, 2017: Journal of Urology
Giacomo Verzotti, Vanessa Fenner, Gregory Wirth, Christophe E Iselin
Acute urinary retention is one of the most frequent urologic emergencies. It occurs mostly in elderly males that suffer from prostate enlargement. Very rare in women, it is essentially caused by vaginal prolapse and neurologic disease. Patients with acute urinary retention suffer from lower abdominal pain and cannot void. Medical history is the cornerstone of diagnosis. Rarely palpable on abdominal examination, an overfilled bladder may be revealed by dullness on supra-pubic percussion. Acute urinary retention may lead to a decrease in kidney function, and on the long term to detrusor hypocontractility...
November 30, 2016: Revue Médicale Suisse
Midori Sasaki Yatabe, Kimio Watanabe, Yoshimitsu Hayashi, Junichi Yatabe, Satoshi Morimoto, Atsuhiro Ichihara, Masaaki Nakayama, Tsuyoshi Watanabe
The clinical picture of IgG4-related disease (IgG4-RD) is diverse because various organs can be affected. We describe the case of a 56-year-old man with acute renal failure and tuberoinfundibular hypophysitis due to IgG4-RD. Steroid therapy lowered the serum IgG4 level and ameliorated renal dysfunction, bilateral hydronephrosis and retroperitoneal fibrosis. However, polyuria from post-obstructive diuresis and unmasked central diabetes insipidus ensued. The patient's polyuria continued despite the administration of a therapeutic dose of glucocorticoid; the patient's pituitary swelling and anterior pituitary dysfunction were partially ameliorated...
2017: Internal Medicine
Mallar Bhattacharya, Richard H Kallet, Lorraine B Ware, Michael A Matthay
Negative-pressure pulmonary edema (NPPE) or postobstructive pulmonary edema is a well-described cause of acute respiratory failure that occurs after intense inspiratory effort against an obstructed airway, usually from upper airway infection, tumor, or laryngospasm. Patients with NPPE generate very negative airway pressures, which augment transvascular fluid filtration and precipitate interstitial and alveolar edema. Pulmonary edema fluid collected from most patients with NPPE has a low protein concentration, suggesting hydrostatic forces as the primary mechanism for the pathogenesis of NPPE...
October 2016: Chest
Yutaka Yoneoka, Shoji Kaku, Shunichiro Tsuji, Hiroto Yamashita, Takashi Inoue, Fuminori Kimura, Takashi Murakami
BACKGROUND: Vesicoureteral reflux is thought to predispose to urinary tract infection and renal scarring, and ureteral reimplantation in childhood remains the gold standard for its treatment. It has been reported that the risk of postrenal failure during pregnancy is increased among women with Politano-Leadbetter ureteral reimplantation. In previous case reports on patients with progressive hydronephrosis and renal failure during pregnancy after ureteral reimplantation, percutaneous nephrostomy was always required, so there has been no information about the clinical management of such patients by ureteral stenting...
April 1, 2016: BMC Pregnancy and Childbirth
M Irani, N Fisher, A Mor, G Bensinger
Urinary retention is an emergency that rarely occurs during pregnancy. Previous case reports have suggested multiple risk factors that can cause the gravid uterus to become impacted in the pelvis leading to lower bladder or urethral compression with subsequent urinary retention. However, no cases of urinary obstruction in a pregnancy that was complicated with severe electrolyte imbalance have been reported. To our knowledge, we report the first case of a 31-year-old woman presenting at 8 weeks' gestation with acute urinary retention caused by a retroflexed, retroverted uterus with a 6-cm posterior uterine fibroid leading to syndrome of inappropriate antidiuretic hormone secretion and severe hyponatremia requiring intensive care unit admission...
June 2016: Journal of Obstetrics and Gynaecology Research
Slobodanka Lj Beatovic, Dragana P Sobic-Saranovic, Emilija D Jaksic, Vera M Artiko, Boris Ajdinovic
UNLABELLED: Diuretic nephrogram is important diagnostic tool in the postnatal follow-up of asymptomatic antenatally detected hydronephrosis (HN). In the last decades, two quantitative indices of renal excretion, output efficiency and the residual kidney counts normalized to the 1-2min counts (normalized residual activity, NORA) have been proposed, that enhance the accuracy of technique to detect kidneys with obstruction. Unfortunately, in many nuclear medicine departments in developing countries the obsolete computer systems do not give the opportunity of sophisticated analysis of nephrogram...
September 2015: Hellenic Journal of Nuclear Medicine
Uday Guled, Vijay G Goni, Arjun R H Honnurappa, Rakesh John, Harsha Vardhana, Gaurav Sharma, Kirubakaran S Pattabhiraman
BACKGROUND: Suprapubic catheter (SPC) insertion is a common urological procedure. Though considered a simple and safe procedure, complications are bound to occur if proper precautions are not taken during the procedure. The reported complications include gross hematuria, post-obstruction diuresis, insertion site skin-related complications, and intra-abdominal visceral injuries. Iatrogenic bowel injuries have been reported to occur as a complication in around 2.5% of cases. CASE REPORT: We report a very rare case of a bowel injury due to improper insertion of a SPC leading to fecal matter tracking along the muscle planes to reach the fracture site of the femur shaft and formation of an external fecal fistula along the lateral aspect of thigh, which according to us is the first reported case in the literature...
October 6, 2015: American Journal of Case Reports
Vural Taner Yılmaz, Ali Berkant Avcı, Ali Feyzullah Şahin, Hasan Bozkurt, Faruk Doğan
Herein, we present a successfully treated case with acute renal failure due to ureteral obstruction caused by total uterine prolapsed. A 55-year-old female patient presented to our hospital with the complaints of protrusion of the uterus for the last 3 months, pollakiuria, nocturia, decreased urine volume, and swelling of her body for the last week, and as well as impaired general status with shortness of breath for the last several days. Her physical examination revealed a blood pressure of 140/90 mmHg, pulse rate of 80 beats/min, body temperature of 37...
July 2013: Renal Failure
M Ahmed, A Abubakar, A T Lawal, A Bello, H Y Maitama, H N Mbibu
We carried out a prospective study of consecutive patients who presented with chronic urinary retention over a period of 2 years in order to determine the safety and effectiveness of rapid and complete decompression of chronic urinary retention. A total of 22 patients met the inclusion criteria. Although slow decompression is thought to reduce complications, it harbours the disadvantages of impracticability, time and labour demands and an increased risk of infection. Post-obstructive diuresis, haematuria and hypotension are relatively frequent in rapid and complete decompression of chronic urinary retention...
January 2013: Tropical Doctor
Aïcha Hamdi, David Hajage, Emmanuel Van Glabeke, Xavier Belenfant, François Vincent, Frédéric Gonzalez, Magali Ciroldi, Edouard Obadia, Riad Chelha, Jean-Louis Pallot, Vincent Das
UNLABELLED: Study Type--Therapy (case series) Level of Evidence 4. What's known on the subject? and What does the study add? The pathophysiology of post-renal acute kidney injury (PR-AKI), i.e. caused by urinary tract obstruction, has been extensively studied in animal models but clinical studies on this subject are outdated, and/or have focused on the mechanisms of 'post-obstructive diuresis' (POD), a potentially life-threatening polyuria that can develop after the release of obstruction...
December 2012: BJU International
Brenda J Francis, Raegan J Wells, Sangeeta Rao, Timothy B Hackett
Urethral obstruction is a common medical emergency in cats. Frequency of post-obstruction diuresis in cats following resolution of urethral obstruction is unknown. The objective of this study was to document frequency and associated clinical features of post-obstruction diuresis in cats. The records of 32 cats undergoing 33 admissions to the Colorado State University Veterinary Hospital for urethral obstruction were reviewed. Signalment, admission blood values, fluid therapy, and urine output were recorded...
August 2010: Journal of Feline Medicine and Surgery
Mark R Quinlan, Peter Cronin, Padraig J Daly, Ronald W G Watson, Walter Manucha, Neil G Docherty, John M Fitzpatrick
BACKGROUND/AIMS: Unilateral ureteral obstruction (UUO) results in renal injury. Studies report increased injury indices in male rats following UUO. Our study examined whether this gender-based renal response to UUO was reflected in sustained differences following relief of obstruction. METHODS: Adult male/female rats (200-400 g) were subjected to either sham surgery (S/RN) or UUO (UUO/RN). At 24 h, obstruction was relieved and all animals underwent contralateral nephrectomy...
2010: Kidney & Blood Pressure Research
Niovi Karavida, Sandip Basu, Philip Grammaticos
Facticious accumulation of the radiopharmaceutical in the urinary draining system as shown by routine renal tests, like technetium- 99m-diethylenetriamine pentacetic acid, technetium-99m-mercaptylacetyltriglycine or technetium-99m-glucoheptonate renograms can be re-evaluated by administering a diuretic, like furosemide (FS) and obtaining post FS dynamic and static images. Urinary tract obstruction can thus be identified. Partial urinary tract obstruction, the effectiveness of stenting, the effectiveness of obstruction correcting surgery and retroperitoneal lymph nodes, may be diagnosed after FS induced diuresis...
January 2010: Hellenic Journal of Nuclear Medicine
R van Mastrigt, J J M Pel, J W N C Huang Foen Chung, S de Zeeuw
OBJECTIVES: A non-invasive method to measure the bladder pressure in males using a condom catheter has been developed. The measurement technique, its validation and limitations, a diagnostic nomogram to non-invasively diagnose bladder outlet obstruction (BOO), and results of large-scale application are discussed. METHODS: Modified incontinence condoms are attached to the penis. During voiding the flow of urine is mechanically interrupted. The subsequent maximum pressure in the condom reflects the isovolumetric bladder pressure...
January 2009: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Maria Jose Martinez Urrutia, P López Pereira, L F Avila Ramirez, R Lobato Romera, C García Meseguer, E Jaureguizar Monereo
OBJECTIVE: To evaluate the transplantation of both kidneys from donors under 3 years old to older pediatric recipients, in order to provide adequate renal mass and improve graft survival. PATIENTS AND METHODS: Seven patients received a double kidney transplant from a donor under 3 years old (mean age 2.7 years). The primary renal disease was obstructive uropathy in two patients, and hemolytic uraemic syndrome, tuberous sclerosis, nephronoptisis, reflux nephropathy and nephrotic syndrome (one patient each)...
August 2006: Journal of Pediatric Urology
M J Frade Mera, S Jacue Izquierdo, G Fontan Vinagre, J C Montejo González
OBJECTIVE: Describe the course and immediate post-operative care in patients with intestinal transplant. MATERIAL AND METHODS: Descriptive, prospective study conducted in the Polyvalent Intensive Care Unit of a tertiary hospital for one year. Variables analyzed during the first 48 hours of the post-operative period: vital signs, O2 saturation, weaning time, diuresis, glycemia, catheters, drains, ileostomy, gastrostomy, TISS, NEMS, nursing cares, APACHE II and SAPS II on admission...
April 2007: Enfermería Intensiva
Joanne D Samuel, Rupesh I Bhatt, Richard J Montague, Noel W Clarke, Vijay A C Ramani
PURPOSE: There is little consensus regarding long-term followup of renal function in patients who undergo urinary diversion. We established the usefulness of combined serial isotopic glomerular filtration rate measurement and diuresis renography in the early identification of patients at risk for deterioration of renal function following ileal conduit diversion. MATERIALS AND METHODS: A total of 340 patients with ileal conduit diversion who were followed between 1990 and 2000 were identified...
December 2006: Journal of Urology
I J de Jong, H Veeken, K van der Heide, W Hart
A 70-year-old man with clinically localised prostate carcinoma underwent extraperitoneal endoscopic radical prostatectomy. His medical history revealed hypertension, renal colic, hypogonadotropic hypogonadism and recurrent deep venous thrombosis in the legs. The operation was uneventful with 500 ml blood loss and no periods ofhypotension. The patient developed oliguria within 12 h after surgery. A hypovolemic state was initially suggested to explain the oliguria and increasing amounts of intravenous fluids were administered...
December 3, 2005: Nederlands Tijdschrift Voor Geneeskunde
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