Acute kidney injury caused by intravascular hemolysis after mechanical thrombectomy.
BACKGROUND
A 43-year-old African-American female (gravida 5 para 0) with an 8-week intrauterine pregnancy presented to the emergency room with crampy abdominal pain, shortness of breath, and shoulder pain. She had normal renal function on admission. CT angiography of the chest revealed bilateral pulmonary emboli; therefore, the AngioJet (Possis Medical, Inc., Minneapolis, MN) device was used to perform mechanical thrombolysis. The patient subsequently developed hyperkalemia, red urine and anuria.


METHODS
Physical examination, measurement of serum creatinine level and electrolytes, dipstick urinalysis and centrifugation of urine and blood.


METHODS
Acute kidney injury due to hemoglobinuria as a result of non-immune-mediated intravascular hemolysis following the use of a percutaneous mechanical thrombectomy device (AngioJet).


RESULTS
Hydration, alkalinization of urine and initiation of hemodialysis (temporarily switched to continuous venovenous hemodiafiltration). Urine output improved after the 20th day of hospitalization, at which point dialysis was discontinued. The patient's renal function completely recovered by day 25.
Dukkipati
Ramnath
R
David Geffen School of Medicine at UCLA, Interventional Nephrology, Harbor-UCLA Medical Center, Torrance, CA 90502, USA. ramdukkipati@gmail.com
Yang
Eric H
EH
Adler
Sharon
S
Vintch
Janine
J
D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy; D000328:Adult; D005260:Female; D006440:Hemofiltration; D006461:Hemolysis; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000601:surgery*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000601:surgery*; D006435:Renal Dialysis; D017131:Thrombectomy / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed