• Internal medicine · Jan 2021

    Review Case Reports

    Pyuria without Casts and Bilateral Kidney Enlargement are Probable Hallmarks of Severe Acute Kidney Injury Induced by Acute Pyelonephritis - A Case Report and Literature Review.

    • Kohei Odajima, Ryo Togashi, Yoshikazu Nemoto, Yuto Hayama, Shinichiro Asakawa, Michito Nagura, Shigeyuki Arai, Osamu Yamazaki, Yoshifuru Tamura, Makoto Mochizuki, Ryuji Ohashi, Shigeru Shibata, and Yoshihide Fujigaki.
    • Department of Internal Medicine, Teikyo University School of Medicine, Japan.
    • Intern. Med. 2021 Jan 15; 60 (2): 293298293-298.

    AbstractThe patient was a 38-year-old man who had experienced nausea and fever for a few days and presented with back pain, oliguria, and pyuria, suggesting acute pyelonephritis (APN). He showed acute kidney injury (AKI) with bilateral kidney enlargement and was using nonsteroidal anti-inflammatory drugs (NSAIDs). AKI-induced by APN was confirmed by kidney biopsy. The AKI was successfully treated with antibiotic therapy. A search of the relevant literature for reports on histopathologically-proven APN-induced severe AKI revealed that the key characteristics were bilateral kidney enlargement with pyuria without casts. Oligoanuria was frequently associated with APN-induced severe AKI, and NSAID use may be a possible risk factor. Prompt antibiotic treatment based on the clinical characteristics of APN-induced AKI can improve the renal outcome.

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