title: Scattered striated persistent nephrogram in sepsis.
abstract: Persistent nephrogram, the hallmark of radiocontrast-induced kidney failure, is usually homogenous throughout the kidney and is considered as a generalized shutoff of glomerular filtration, the consequence of altered glomerular hemodynamics, affecting most glomeruli. Herein, we report an incidental finding of scattered persistent nephrogram that was noted in a septic prediabetic hypertensive patient during computerized tomography-guided drainage of a liver abscess. The peculiar patchy striated distribution pattern suggests more centrally altered renal hemodynamics, with hypoperfusion at the level of interlobar and intralobular arteries. Altered renal microcirculation in this case is likely related to the combined effects of prediabetes, sepsis and contrast medium upon renal blood flow regulation, perhaps with consequent focal hypoxic tubular damage.
authors.affiliation: Department of Medicine, Hadassah Hebrew University Hospital, Mt. Scopus, Jerusalem, Israel.
authors.forename: Itamar
authors.initials: I
authors.lastname: Sagiv
authors.forename: Benjamin
authors.initials: B
authors.lastname: Koslowsky
authors.forename: Maya
authors.initials: M
authors.lastname: Korem
authors.forename: Nurith
authors.initials: N
authors.lastname: Hiller
authors.forename: Samuel N
authors.initials: SN
authors.lastname: Heyman
mesh_terms: D004322:Drainage; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000601:surgery; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology*; D008100:Liver Abscess / Q000000981:diagnostic imaging / Q000209:etiology; D008875:Middle Aged; D011379:Prognosis; D012079:Renal Circulation; D018805:Sepsis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed