title: Pseudo-renal failure: bladder rupture with urinary ascites.
abstract: We report a case of pseudo-renal failure caused by urinary ascites due to spontaneous bladder rupture following transurethral resection of a bladder tumour (TUR-BT). A 63-year-old man presented with 2 months of abdominal distension due to ascites. Laboratory findings showed elevated serum creatinine and hyperkalaemia. Peritoneal fluid urea, creatinine and potassium levels were greater than those in serum levels. CT scan showed partial wall thinning in the bladder wall, and cystography indicated fragility in the dome where the latest TUR-BT was performed. Pseudo-renal failure (laboratory abnormalities of acute kidney injury in the setting of normal kidney function) from urinary ascites and reverse intraperitoneal dialysis was diagnosed. Symptoms and laboratory abnormalities improved promptly with insertion of a urinary catheter. This report aims to increase recognition of urinary ascites when a patient with genitourinary surgical procedures or radiation therapy, or blunt abdominal trauma, presents with ascites and elevated creatinine simultaneously.
authors.affiliation: Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Matsumura
authors.affiliation: Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan.
authors.forename: Naokatsu
authors.initials: N
authors.lastname: Ando
authors.affiliation: Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Kumabe
authors.affiliation: VA Medical Center, San Francisco, California, USA.
authors.forename: Gurpreet
authors.initials: G
authors.lastname: Dhaliwal
mesh_terms: D000005:Abdomen / Q000473:pathology*; D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism; D001201:Ascites / Q000150:complications*; D002404:Catheterization; D003404:Creatinine / Q000097:blood*; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism / Q000628:therapy; D012421:Rupture; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000209:etiology; D001743:Urinary Bladder / Q000473:pathology*; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D062885:Urinary Catheters
chemical_list: D003404:Creatinine