Nephrotoxic acute renal failure in a renal transplant patient with recurrent lymphocele treated with povidone-iodine irrigation.
Povidone-iodine sclerosis has been suggested in the literature as a safe and effective treatment for post-renal transplant lymphoceles. No significant complications of this method have been described. We report on a kidney allograft recipient with recurrent lymphoceles treated with povidone-iodine instillations who developed acute renal failure secondary to iodine intoxication. Four days after the beginning of the povidone-iodine irrigations, metabolic acidosis was present, and renal function started to deteriorate. After a few days, despite the suspension of irrigations, the patient developed oliguria, and dialysis was needed. A renal biopsy was performed, and intense acute tubular necrosis was the only relevant finding. The lymphocele was corrected surgically, and the patient eventually recovered. As has been described in other settings, povidone-iodine instillation for the treatment of post-renal transplant lymphoceles may lead to iodine kidney toxicity and acute renal failure.
Renal Transplant Unit, Division of Nephrology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul School of Medicine, Porto Alegre, RS, Brazil. rmanfro@portoweb.com.br
Roberto C
RC
Manfro
Liriane
L
Comerlato
Roberto H
RH
Berdichevski
Adriana R
AR
Ribeiro
Nancy T
NT
Denicol
Milton
M
Berger
David
D
Saitovitch
Walter J
WJ
Koff
Luis F
LF
Gonçalves
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008210:Lymphocele / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology* / Q000601:surgery; D011206:Povidone-Iodine / Q000009:adverse effects* / Q000627:therapeutic use; D012008:Recurrence; D006435:Renal Dialysis / Q000379:methods; D007507:Therapeutic Irrigation / Q000009:adverse effects / Q000379:methods
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011206:Povidone-Iodine