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Arteriovenous fistula in a renal allograft with gross hematuria and subsequent acute kidney injury due to urinary tract obstruction: a case report.
- Source :
-
BMC nephrology [BMC Nephrol] 2023 Jun 05; Vol. 24 (1), pp. 156. Date of Electronic Publication: 2023 Jun 05. - Publication Year :
- 2023
-
Abstract
- Background: Arteriovenous fistula (AVF) due to renal allograft biopsy is mechanical trauma resulting from the penetration of small arteries and veins by a core needle. Most AVFs are reported to resolve asymptomatically and spontaneously. This report presents a patient with acute kidney injury (AKI) due to urinary tract obstruction caused by a bleeding AVF in a renal allograft.<br />Case Presentation: A 22-year-old Japanese woman who underwent living-donor kidney transplantation (KT) at 3 years due to end-stage renal disease caused by focal segmental glomerulosclerosis (FSGS) presented with a renal transplant AVF (gourd-shaped; 42 × 19 × 20 mm). The AVF was unexpectedly discovered by ultrasound before a surveillance biopsy at 10 years after KT. The patient had a history of recurrent FSGS, had undergone several renal allograft biopsies after KT, and did not experience symptoms or growth of the AVF for years. Nineteen years after KT, the patient developed AKI with sudden, asymptomatic, gross hematuria and anuria. Plain computed tomography revealed a hematoma in the pelvis of the renal allograft and bladder tamponade. The AVF was successfully treated by coil embolization. Hemodialysis was performed for AKI, and graft function was gradually recovered.<br />Conclusions: Unexpected bleeding from a renal transplant AVF may lead to transplant dysfunction. Angiographic embolization against the ruptured renal transplant AVF may prevent rebleeding and rescue the renal allograft.<br /> (© 2023. The Author(s).)
- Subjects :
- Female
Humans
Young Adult
Adult
Hematuria complications
Kidney pathology
Allografts
Kidney Transplantation adverse effects
Glomerulosclerosis, Focal Segmental pathology
Arteriovenous Fistula complications
Arteriovenous Fistula diagnostic imaging
Acute Kidney Injury therapy
Acute Kidney Injury complications
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2369
- Volume :
- 24
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC nephrology
- Publication Type :
- Academic Journal
- Accession number :
- 37277729
- Full Text :
- https://doi.org/10.1186/s12882-023-03183-5