The 489th case: acute kidney injury, gross hematuria, nephrotic syndrome

VernacularTitle:第489例——急性肾损伤、肉眼血尿、肾病综合征
Author: Huaiya XIE ; Mingyue GUO ; Li JIANG ; Gang CHEN ; Wei YE ; Xuemei LI
From: Chinese Journal of Internal Medicine 2021;60(6):589-592
CountryChina
Language:Chinese
Abstract: Onset with fever and back pain, an 81-year-old man had sudden oliguria and progressively elevated serum creatine from normal range to 660 μmol/L within 1 week after receiving contrast agents, various antibiotics, and several nonsteroidal anti-inflammation drugs. Urine output recovered after supportive treatment. However, his serum creatinine level rose again soon after a temporary decline accompanied by gross hematuria with almost normal morphology, nephrotic proteinuria, and hypoalbuminemia. Renal biopsy revealed necrotizing glomerulonephritis. Methylprednisolone was intravenously administrated 500 mg per day for 3 days, followed by oral glucocorticoids and cyclophosphamide. Gradually the patient′s serum creatinine descended to 144 μmol/L.