Open AccessUnusual causes of Hematuria in dialysis patients: Diagnostic dilemma, risks and management
Author(s) -
Santosh Kumar,
Bhuvanesh Nanjappa,
Yogesh R. Barapatre,
Seema Prasad,
Raguram Ganesamoni,
Manish Rathi
Publication year - 2013
Publication title -
journal of emergencies, trauma and shock
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.313
H-Index - 29
eISSN - 0974-519X
pISSN - 0974-2700
DOI - 10.4103/0974-2700.120374
Subject(s) - medicine , nephrectomy , hemodialysis , abnormality , dialysis , surgery , cyst , abdominal pain , kidney disease , shock (circulatory) , disease , radiology , kidney , psychiatry
Two male patients with end-stage renal disease (ESRD) developed a spontaneous hemorrhage of one of their native kidneys and were referred to our institution. Symptoms included sudden onset abdominal pain, hematuria and shock. Symptoms were associated with a hemoglobin decrease. Computerized tomography (CT) was done and nephrectomy undertaken in both the cases. Histologic findings confirmed bleeding and there was no abnormality other than those related to renal insufficiency (cysts and atrophy). In chronic hemodialysis (HD) patients with hematuria, if other common causes are not identified spontaneous subcapsular or renal cyst rupture should be kept in mind. Surgery is our preferred treatment because of the diagnostic dilemma of tumors and the potential mortality of massive hematomas in morbid patients.