Acute renal failure during a trial of spinal cord stimulation: theories as to a possible connection.
OBJECTIVE
This is the first case describing an episode of acute renal failure occurring during a spinal cord stimulation trial.


METHODS
A 48-year-old male with a history of hypertension and 3 prior failed spine surgeries underwent a trial of spinal cord stimulation for uncontrolled bilateral lower extremity neuropathic pain. Two days after the placement of the percutaneous stimulator lead the patient returned complaining of 3 syncopal episodes. He was found to be hypotensive and in acute renal failure with a creatinine of 8.1 and a BUN of 83.


METHODS
The stimulator lead was immediately removed. The patient was admitted to the intensive care unit and responded promptly to rehydration and placement of a urinary catheter. His renal and urological work-ups revealed no significant abnormalities.


CONCLUSIONS
The development of the episode of acute renal failure may have been influenced by the secondary effects of spinal cord stimulation. Since acute renal failure has never been associated with the use of spinal cord stimulation, this singular example does not by itself demonstrate a relationship. However, if future episodes are seen, a link between the 2 events could be drawn. For now, it is not clear if the development of this patient's acute renal failure could, in part, be attributed to the use of the spinal cord stimulator or if it was merely coincidental in nature. We do feel it is useful for the clinician to understand the pathophysiologic changes associated with spinal cord stimulation and to see how, at least in theory, there could be a connection.
Larkin
Thomas M
TM
Parkway Neuroscience and Spine Institute, Hagerstown, MD 21740, USA. larkintm@comcast.net
Dragovich
Anthony
A
Cohen
Steven P
SP
D058186:Acute Kidney Injury / Q000209:etiology*; D004599:Electric Stimulation Therapy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000473:pathology; D059408:Pain Management; D013116:Spinal Cord / Q000503:physiopathology / Q000528:radiation effects