Pyuria without Casts and Bilateral Kidney Enlargement Are Probable Hallmarks of Severe Acute Kidney Injury Induced by Acute Pyelonephritis: A Case Report and Literature Review.

Abstract

The patient was a 38-year-old man who had experienced nausea and fever for a few days and presented with back pain, oliguria, and pyuria, suggesting acute pyelonephritis (APN). He showed acute kidney injury (AKI) with bilateral kidney enlargement and was using nonsteroidal anti-inflammatory drugs (NSAIDs). AKI-induced by APN was confirmed by kidney biopsy. The AKI was successfully treated with antibiotic therapy. A search of the relevant literature for reports on histopathologically-proven APN-induced severe AKI revealed that the key characteristics were bilateral kidney enlargement with pyuria without casts. Oligoanuria was frequently associated with APN-induced severe AKI, and NSAID use may be a possible risk factor. Prompt antibiotic treatment based on the clinical characteristics of APN-induced AKI can improve the renal outcome.

• Authors: Kohei Odajima, Ryo Togashi, Yoshikazu Nemoto, Yuto Hayama, Shinichiro Asakawa, Michito Nagura, Shigeyuki Arai, Osamu Yamazaki, Yoshifuru Tamura, Makoto Mochizuki, Ryuji Ohashi, Shigeru Shibata, Yoshihide Fujigaki
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 60 Issue 2 Pg. 293-298 (Jan 15 2021) ISSN: 1349-7235 [Electronic] Japan
• PMID: 32893233 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal

Topics

• Acute Kidney Injury (diagnosis, etiology)
• Adult
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
• Humans
• Kidney
• Male
• Pyelonephritis (complications, diagnosis)
• Pyuria