A Case of Postrenal Acute Renal Failure due to Hemorrhagic Cystitis

Korean Journal of Nephrology 2010;29(1):144-148.

Jin Kang, M.D.1, Sang Heon Song, M.D.2, Won Lim, M.D.2, Jungmin Son, M.D.2 Eun Young Seong, M.D.2, Dong Won Lee, M.D.2 and Ihm Soo Kwak, M.D.2

Department of Internal Medicine¹
Seoho Hospital Department of Internal Medicine²
Pusan National University School of medicine, Busan, Korea

증례 : 출혈성 방광염에 의해 유발된 신후성 급성 신부전 1예

강 진1, 송상헌2, 임 원2, 손정민2, 성은영2, 이동원2, 곽임수2

서호병원 내과1 , 부산대학교 의학전문대학원 내과학교실2

Abstract

Hemorrhagic cystitis (HC), a serious form of cystitis, is characterized by diffuse bladder mucosal inflammation with hemorrhage. The known causes of HC are radiation, chemotherapy, drug, and infection. But, most cases happen without definite etiology. Radiation induced HC can be developed at any time from 6 months to 10 years after pelvic irradiation therapy, and can appear as late as 2 decades. The complications of HC are anemia, chronic cystitis, and acute renal failure (ARF). However, HCinduced severe postrenal ARF is rare. We experienced a case of a postrenal ARF caused by hematoma in HC. A 55-year-old woman had past history of pelvic irradiation therapy for carcinoma of the cervix 13 years ago. She was initially treated by bladder catheterization and bladder irrigation with normal saline. HC and renal function were improved. However, HC was recurred shortly after stopping irrigation and serum creatinine was elevated again. Thus, we treated this patient successfully with both percutaneous nephrostomy and antegrade double J stent catheterization.

Key Words: Acute renal failure, Radiation, Cystitis