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http://dx.doi.org/10.3339/jkspn.2013.17.2.117

Acute Kidney Injury and Postobstructive Diuresis Caused by a 4 mm Urinary Calculus  

Jung, Eui Seok (Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School)
Yang, Eun Mi (Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School)
Kim, Chan Jong (Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School)
Publication Information
Childhood Kidney Diseases / v.17, no.2, 2013 , pp. 117-121 More about this Journal
Abstract
Urinary obstructions from ureteral calculi are one of the causes of postrenal acute kidney injury (AKI). Here we present a case of AKI caused by a 4 mm ureteral calculus with postobstructive diuresis following the spontaneous passage of the calculus. A 13-year-old girl who underwent nephrectomy for the removal of a neuroblastoma eight years previously, visited our institution because anuria had developed over the preceding five days. The serum creatinine level was elevated at 13.4 mg/dL. Radiological examinations showed the right solitary kidney with moderate hydronephrosis and a 4 mm calculus in the upper right ureter. The patient immediately underwent hemodialysis. After the ureteral calculus was passed spontaneously on day 2 of hospitalization, urinary output increased to more than 5,200 mL per day. Intravenous fluid replacement with careful monitoring of weight, intake, output, and serum and urine electrolytes was performed. On day 5 of hospitalization, the patient's condition stabilized.
Keywords
Calculi; Obstruction; Acute kidney injury; Polyuria; Anuria;
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