Obstructive Nephropathy Without Hydronephrosis: Suspicion Is the Key

Don H Esprit; Abhilash Koratala; Volodymyr Chornyy; Charles S Wingo

doi:10.1016/j.urology.2016.11.041

Obstructive Nephropathy Without Hydronephrosis: Suspicion Is the Key

Urology. 2017 Mar:101:e9-e10. doi: 10.1016/j.urology.2016.11.041. Epub 2016 Dec 21.

Authors

Don H Esprit¹, Abhilash Koratala², Volodymyr Chornyy¹, Charles S Wingo¹

Affiliations

¹ Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, FL.
² Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, FL. Electronic address: akoratsla@ufl.edu.

PMID: 28011273
DOI: 10.1016/j.urology.2016.11.041

Abstract

Urinary tract obstruction leading to acute kidney injury is usually associated with bilateral hydroureters and hydronephrosis, often accompanied by oliguria. We present an atypical case of obstructive uropathy without these features that presented with severe acute kidney injury. A 64-year-old male with no known medical history has presented with a 2-week history of nausea, decreased appetite, flank pain, and lower extremity edema, and was found to have an elevated creatinine of 10.5 mg/dL. Renal ultrasound showed mild prominence of the bilateral renal collecting systems with no evidence of hydronephrosis. Computed tomography scan showed findings suggestive of retroperitoneal fibrosis involving ureteral region and bilateral ureteral stent placement has led to dramatic improvement of creatinine to 1.3 mg/dL over the next 4 days.