| Acute renal failure due to bilateral pieloureteral stone impaction in a 10-month-old boy. | |
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MedLine Citation:
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PMID: 20464442 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Urolithiasis (UL) can present with its classic signs and symptoms, such as flank or abdominal pain and gross hematuria. However, atypical complaints can be more common in younger children. We report here a case of bilateral ureteropelvic junction (UPJ) stones in a 10-month-old boy who only showed nonspecific symptoms at the time of presentation. The initial blood test revealed renal failure (serum creatinine 3.4 mg/dl), hyperkalemia (6.4 mEq/l), hyperphosphoremia (9.4 mEq/l) and mild metabolic acidosis. Medical treatment for electrolyte disorders was started. The ultrasonography revealed impacted stones in both ureteropelvic junctions. A pigtail catheter was placed in each ureter. High urine flow was promptly achieved after the pigtail procedure, and the serum creatinine level dropped quickly from 4.5 to 0.32 mg/dl. Quantitative determination of urinary amino acids by ion exchange chromatography showed high cystine levels of 8.43 mmol/g creatinine. Outpatient follow-up was scheduled every 3 months to monitor patient compliance with potassium citrate. In the first 6 months, the patient underwent three febrile urinary tract infections (UTIs). Since both pigtail catheters were removed, he has been free of UTIs and stones. Our case emphasizes the need for considering UL in infants who complain with unclear signs, because UL can only show nonspecific symptoms in children younger than 1 year old. Since cystinuria can cause loss of renal function due to urinary system obstruction and UTI, an early diagnosis and a close follow-up are the key to achieving the best long-term outcome. |
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Authors:
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Gabriel Miguel Cara Fuentes; Laura Espinosa Roman; Marta Melgosa Hijosa; Mercedes Navarro Torres |
Publication Detail:
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Type: Case Reports; Letter Date: 2010-05-13 |
Journal Detail:
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Title: Clinical and experimental nephrology Volume: 14 ISSN: 1437-7799 ISO Abbreviation: Clin. Exp. Nephrol. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-03 Completed Date: 2010-11-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9709923 Medline TA: Clin Exp Nephrol Country: Japan |
Other Details:
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Languages: eng Pagination: 401-3 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Kidney Injury
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diagnosis,
etiology*,
therapy Cysteine / urine Cystinuria / complications, diagnosis*, therapy Fluid Therapy Humans Infant Isotonic Solutions Male Potassium Citrate / administration & dosage Sodium Chloride / administration & dosage Treatment Outcome Ureteral Calculi / complications*, diagnosis, therapy Ureteral Obstruction / diagnosis, etiology*, therapy Urinary Catheterization Urinary Tract Infections / etiology |
| Chemical | |
Reg. No./Substance:
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0/Isotonic Solutions; 52-90-4/Cysteine; 6100-05-6/Potassium Citrate; 7647-14-5/Sodium Chloride |
| Comments/Corrections | |
Comment In:
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Clin Exp Nephrol. 2010 Oct;14(5):520-1
[PMID:
20676719
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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