Castillo RRE, Montalvo DGA, Enríquez RL, Uribe UNO, Morales-Buenrostro LE

Language: Spanish
References: 10
Page: 19-25
PDF size: 273.69 Kb.

ABSTRACT

The rapidly progressive renal failure syndrome corresponds to an acute kidney injury that causes an accelerated decrease of the glomerular filtration rate in hours to days or weeks. After pre-renal causes were dismissed, a differential diagnosis with glomerular causes, vascular causes (thrombosis), obstructive causes, interstitial nephritis and acute tubular necrosis must be established. We describe the case of a rapidly progressive decline of the renal function that was managed with intravenous steroids and freshly frozen plasma due to the diagnostic probability of thrombotic microangiopathy, interstitial nephritis and rapidly progressive glomerulonephritis. Subsequently, an acute tubular necrosis was confirmed by a renal biopsy without any previous clinical evidence suggesting a clear presence or etiology of this entity.

REFERENCES

1. Charles Jennette J. Rapidly progressive crescentic glomerulonephritis. Kidney International. 2003;63(3):1164-77.

2. Ostermann M, Joannidis M. Acute kidney injury 2016: diagnosis and diagnostic workup. Critical Care. 2016;20:299.

3. George J, Nester C. Syndromes of Thrombotic Microangiopathy. New England Journal of Medicine. 2014;371(7): 654-66.

4. Picazo García ML, Pérez-Mies B, Esteban Rodríguez I. El riñón como órgano diana en la microangiopatía trombótica. Revista española de patología. 2002;35:3.

5. Praga M, González E. Acute interstitial nephritis. Kidney International. 2010;77(11):956-61.

6. Muriithi A, Nasr S, Leung N. Utility of Urine Eosinophils in the Diagnosis of Acute Interstitial Nephritis. Clinical Journal of the American Society of Nephrology. 2013; 8(11):1857-62.

7. Chen M, Yu F, Wang S. Antineutrophil Cytoplasmic Autoantibody- Negative Pauci-immune Crescentic Glomerulonephritis. Journal of the American Society of Nephrology. 2007;18(2):599-605.

8. Radhakrishnan J, Cattran D. The KDIGO practice guideline on glomerulonephritis: reading between the guidelines— application to the individual patient. Kidney International. 2012;82(8):840-56.

9. Pons B, Lautrette A, Oziel J. Diagnostic accuracy of early urinary index changes in differentiating transient from persistent acute kidney injury in critically ill patients: multicenter cohort study. Critical Care. 2013;17(2):R56.

10. Zarich S, Fang LST, Diamond JR. Fractional Excretion of Sodium Exceptions to Its Diagnostic Value. Archives of Internal Medicine. 1985;145(1):108-12.