title: Acute renal failure due to uterine prolapse: a case report.
abstract: Herein, we present a successfully treated case with acute renal failure due to ureteral obstruction caused by total uterine prolapsed. A 55-year-old female patient presented to our hospital with the complaints of protrusion of the uterus for the last 3 months, pollakiuria, nocturia, decreased urine volume, and swelling of her body for the last week, and as well as impaired general status with shortness of breath for the last several days. Her physical examination revealed a blood pressure of 140/90 mmHg, pulse rate of 80 beats/min, body temperature of 37.8 °C, as well as uterine prolapse with infection and erosion on the surface of the uterus, crepitating rales in the basal segments of both lungs, and pretibial edema. Results of laboratory analyses were as follows: BUN = 70 mg/dL, Cr = 6.5 mg/dL, CRP = 8.7 mg/dL, and leukocyte = 12,000/mm(3). Blood gas analysis revealed a pH of 7.35 and bicarbonate level of 14 mmol/L. Data obtained from ultrasonography, DTPA scintigraphy, and abdominal CT, which were performed assuming that the patient had post-renal renal failure due to the compression by uterus, supported this assumption. Bilateral nephrostomy catheters were inserted and appropriate fluid-electrolyte therapy for volume status and antibiotherapy were commenced. Renal functions returned to normal levels on the 4th day of therapy and her complaints disappeared. The patient underwent total abdominal hysterectomy and was monitored in terms of renal functions and diuresis. The present case was presented due to its importance for being a quite rare case who dramatically responded to accurate intervention performed in time.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Sivas Numune Hospital, Sivas, Turkey. vuraltaneryl@yahoo.com.tr
authors.forename: Vural Taner
authors.initials: VT
authors.lastname: Yılmaz
authors.forename: Ali Berkant
authors.initials: AB
authors.lastname: Avcı
authors.forename: Ali Feyzullah
authors.initials: AF
authors.lastname: Şahin
authors.forename: Hasan
authors.initials: H
authors.lastname: Bozkurt
authors.forename: Faruk
authors.initials: F
authors.lastname: Doğan
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D014596:Uterine Prolapse / Q000150:complications*