[Adult male with chronic renal failure due to reflux nephropathy that was possibly induced by neurogenic bladder since childhood].
A 38-year-old male with impaired renal function and serious anemia was admitted to our hospital. He had suffered from a disorder of urination since early childhood and been diagnosed as having neurogenic bladder by an urologist when he was 20 years old. Since February 2007, general fatigue emerged and gradually worsened. In addition, he began to feel nauseous around February 2008. He visited a family doctor and was diagnosed with renal failure and anemia both of which were serious. H e was referred t o our office and admitted immediately because his blood test showed a serum creatinine level of 4.4 mg/dL and hemoglobin of 3.1 g/dL. The initial study with ultrasonograhy suggested that both kidneys contained multiple cysts for the most part, likely due to hereditary polycystic kidney disease. However, a subsequent series of diagnostic imaging tests, including computed tomography and magnetic resonance urography, determined that the cause of renal failure was most likely reflux nephropathy due to secondary vesicouretral reflux induced by the chronic neurogenic bladder. Moreover, the upper gastrointestinal endoscopic examination showed that the cause of anemia was probably the persistent bleeding from gastric antral vascular ectasia. Reflux nephropathy emerges in early childhood and slowly progresses to chronic renal failure in some cases. According to the literature, it is not rare as a cause of end-stage kidney failure even among adult populations. Diagnostic imaging of severe reflux nephropathy is apparently similar to that of polycystic kidney disease. We herein present an adult male with chronic renal failure due to reflux nephropathy, the images of which were similar to polycystic kidney disease.
Tabata
Taku
T
Department of Nephrology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
Suzuki
Hitoe
H
Nakamura
Yuya
Y
Morito
Taku
T
Yabuki
Yasuko
Y
Shibuya
Asuka
A
Ando
Minoru
M
D000328:Adult; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D007690:Polycystic Kidney Diseases; D001750:Urinary Bladder, Neurogenic / Q000150:complications*; D014718:Vesico-Ureteral Reflux / Q000209:etiology*