頁籤選單縮合
題名 | Nonobstructive Acute Pyelonephritis Presenting as Acute Renal Failure in the Elderly=老年人之非阻塞性急性腎盂腎炎以急性腎衰竭表現 |
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作者 | 倪運華; 王甯祺; 陳安; 林裕峰; 張峰義; | 書刊名 | Journal of Medical Sciences |
卷期 | 23:1 2003.02[民92.02] |
頁次 | 頁61-63 |
分類號 | 415.8135 |
關鍵詞 | 老年人急性腎衰竭; 非阻塞性急性腎盂腎炎; Acute renal failure; Bacteremia; Pyelonephritis; |
語文 | 英文(English) |
英文摘要 | Acute renal failure is a rare, but less recognized complication of acute bacterial pyelonephritis in patients who do not have urinary obstruction. We describe an aged woman who developed acute renal failure suffered from severe bilateral flank pain for one week and progressive anorexia, general weakness, decreased urine output and short of breath. She did not have hypotension, fever, leukocytosis and thrombocytopenia. Urinalysis showed numerous leukocytes in the urine. Biochemistry revealed marked renal function impairment with BUN 98 mg/dL and creatinine 7.2 mg/dL. Abdominal sonography demonstrated bilateral enlarged kidney without the evidence of obstruction. Blood and urine cultures grew Escherichia coli. The renal biopsy revealed predominant leukocyte filtration in the interstitium and tubules, compatible with acute pyelonephritis. Antimicrobial therapy and hemodialysis led to rapid improvement in clinical symptoms and renal function. The clinician should be aware that acute bacterial pyelonephritis can cause acute renal failure in the elderly even with no urinary obstruction and hypotension. |
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