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      • Poster Session:PS 0481 ; Nephrology : Analgesic Nephropathy Associated with Total Anuria

        ( Yaloin Onem ),( Ali Kutlu ),( Seyit Ahmet Uslu ),( Barbaros Basbug ),( Muslum Sagir ),( Yusuf Hazcerli ),( Mustafa Hatipoglu ),( Kemal Kara ),( Ramazan Arikan ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Introduction and Aim:While ischemia and nefrotoxins account for almost 45 % of all acute renal failure cases, prerenal (caused by congestive cardiac failure, liquid insuffi - ciency, sepsis and medication) azotemia accounts for around 20%. Among nefrotoxins, nonstereoid anti-infiammatory drugs (NSAII) may affect kidneys through multiple mechanisms (causing hemodynamic, acute allergic interstitial nephritis, papillary necrosis or glomerular nephritis). Herein, we present a patient who developed analgesic nephropathy associated with total anuria. Case: A patient with a medical history of benign prostatic hyperplasia, coronary artery disease, hypertension and tuberculosis was admitted to our department of emergency with complaints of dyspnea and headache. Laboratory examination revealed the following Results: urea: 138 mg/dL, kreatinin: 5,20 mg/dL, BK: 19300, ALT: 319 U/L AST: 324 U/ L LDH: 1947 U/L. The patient was diagnosed with total anuria. Because the patient had a history of analgesic usage, he was scheduled to undergo hemodialysis 3 times per week with a prediagnosis of analgesic nephropathy. Although initially renal function tests demonstrated a slight deterioration (urea: 177 mg/dL and creatinine: 8 mg/dL) they displayed a gradual decrease following ongoing hemodialysis sessions and consequently returned to normal (urea: 48 mg/dL and creatinine: 1, 25 mg/dL). The patient also received piperacillin/tazobactam 3x 2, 25 gr/day due to a concern for aspiration pneumonia. Diagnostic bronchoscopy results were in compliance with fi brosis at microscopic level. Conclusion/Recommendations: Analgesic nefropathy should be investigated when inquiring for the etiology of acute renal failure. Patients with total anuria should receive comprehensive treatment comprising renal replacement therapy such as hemodialysis. Additionally, interstitial lung disease and overlapping aspiration pneumonia may complicate the condition. Therefore, they also should be considered. Even patients with total anuria may return to normal life following a comprehensive and rigorous approach.

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