title: Reflex anuria affecting both kidneys following hysterectomy.
abstract: In situations when there is unilateral ureteral obstruction, the contralateral kidney retains its normal function. In rare instances however, it has been reported that unilateral ureteral obstruction can lead to reflex anuria (RA) and acute renal failure (ARF). Even more unusually, RA with ARF can occur without organic obstruction due to ureteric manipulation during pelvic surgery. We report a 78- year-old woman, who underwent hysterectomy because of endometrial carcinoma. She developed ARF evidenced by anuria of 120-hours duration, and gradual rise of serum creatinine levels to 11.8 mg/dL on the fifth day after hysterectomy. Ultrasound study of the urinary tract revealed bilateral moderate hydronephrosis. Detailed evaluation did not reveal any organic obstruction. She was managed with hemodialysis, control of hypertension and correction of fluid and electrolyte imbalances. By the sixth day, diuresis was established, and the blood urea and serum creatinine levels decreased to normal by the sixteenth day. The patient was finally discharged on the eighteenth day. Our case suggests that urologists and nephrologists should consider RA as one of the causes of anuria and ARF.
authors.affiliation: Department of Nephrology, Ekbatan Hospital, Hamedan University of Medical Sciences and Health Services, Hamedan, Iran. Gholyaf@hotmail.com
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Gholyaf
authors.forename: Saeed
authors.initials: S
authors.lastname: Afzali
authors.forename: Hoshang
authors.initials: H
authors.lastname: Babolhavaegi
authors.forename: Abolfazl
authors.initials: A
authors.lastname: Rahimi
authors.forename: Seyed A
authors.initials: SA
authors.lastname: Wagharseyedayn
mesh_terms: D000368:Aged; D001002:Anuria / Q000209:etiology* / Q000628:therapy; D016889:Endometrial Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D006435:Renal Dialysis