Spontaneous Renal Rupture in Patients on Chronic Hemodialysis.
- Author:
Hye Young YOU
1
;
Sun Wha SONG
;
Chang Hee HAN
;
Jae Wook KIM
;
Young Ok KIM
;
Jung Min YOON
;
Young Soo KIM
;
Bum Soon CHOI
;
Sun Ae YOON
;
Chul Woo YANG
;
Dong Chan JIN
;
Yong Soo KIM
;
Yoon Sik CHANG
;
Byung Kee BANG
Author Information
1. Department of Internal Medicine, Incheon Sarang Hospital, Incheon, Korea.
- Publication Type:Original Article
- Keywords:
Spontaneous renal rupture;
Hemodialysis;
Renal cyst;
Renal cell carcinoma
- MeSH:
Blood Transfusion;
Carcinoma, Renal Cell;
Diabetic Nephropathies;
Dialysis;
Flank Pain;
Glomerulonephritis;
Hematoma;
Hematuria;
Humans;
Incidence;
Male;
Polycystic Kidney, Autosomal Dominant;
Recurrence;
Renal Dialysis*;
Retrospective Studies;
Rupture*
- From:Korean Journal of Nephrology
2004;23(3):453-458
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Because of high incidence of acquired renal cyst and renal malignancy, it is suggested that spontaneous renal rupture more frequently occurs in patients receiving long-term hemodialysis than general population. This study was performed to evaluate the clinical characteristics of spontaneous renal rupture in hemodialysis patients. METHODS: This retrospective study enrolled 12 hemodialysis patients who developed spontaneous renal rupture. We investigated primary renal disease, duration of dialysis, clinical symptoms and signs, radiologic findings, treatment modalities, and histologic findings. RESULTS: The mean age of the patients was 54+/-10 years old and the number of male was 9. Primary renal disease consisted of autosomal dominant polycystic kidney disease (PCKD) (n=5), chronic glomerulonephritis (n=2), diabetic nephropathy (n=1), hypertensive nephropathy (n=1), unknown cause (n=3). Presenting symptoms and signs were sudden onset of flank pain in 9 patients and gross hematuria with mild flank pain in 3 patients. Mean duration from initiation of hemodialysis to development of spontaneous renal rupture was 53+/-36 months. Abdominal computed tomography showed subcapsular or perinephric hematoma in all patients. Of the 7 non-PCKD patients, 6 patients had multiple acquired renal cysts. Surgical exploration was undertaken in 9 patients. Pathologic examination demonstrated small sized-renal cell carcinoma in 2 of 9 patients. Three patients were only treated with conservative management including blood transfusion. All 12 patients recovered without recurrence. CONCLUSION: This study demonstrated that genetic or acquired renal cyst was an important cause of spontaneous renal rupture in hemodialysis patients and presenting manifestations were sudden onset of flank pain and gross hematuria.
