RESUMO
A patient who developed oliguric acute renal failure and nephrotic syndrome within 2 weeks after finishing interferon and ribavirin treatment is reported. At presentation, HCV PCR was negative, and no immunological laboratory test was found altered. A renal biopsy showed collapsing glomerulopathy, and the patient received supportive haemodialysis and high-dose steroids. Twelve days after steroid treatment, renal function started to recover. After 18 weeks, normal renal function and protein/creatinine urinary ratio were achieved and remained normal up to 1-year post-treatment.
RESUMO
Povidone-iodine sclerosis has been suggested in the literature as a safe and effective treatment for post-renal transplant lymphoceles. No significant complications of this method have been described. We report on a kidney allograft recipient with recurrent lymphoceles treated with povidone-iodine instillations who developed acute renal failure secondary to iodine intoxication. Four days after the beginning of the povidone-iodine irrigations, metabolic acidosis was present, and renal function started to deteriorate. After a few days, despite the suspension of irrigations, the patient developed oliguria, and dialysis was needed. A renal biopsy was performed, and intense acute tubular necrosis was the only relevant finding. The lymphocele was corrected surgically, and the patient eventually recovered. As has been described in other settings, povidone-iodine instillation for the treatment of post-renal transplant lymphoceles may lead to iodine kidney toxicity and acute renal failure.
Assuntos
Injúria Renal Aguda/induzido quimicamente , Transplante de Rim/efeitos adversos , Linfocele/tratamento farmacológico , Linfocele/etiologia , Povidona-Iodo/efeitos adversos , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/tratamento farmacológico , Injúria Renal Aguda/cirurgia , Adulto , Ciclosporina/uso terapêutico , Diagnóstico Diferencial , Drenagem/métodos , Feminino , Humanos , Imunossupressores/uso terapêutico , Linfocele/diagnóstico , Linfocele/cirurgia , Povidona-Iodo/uso terapêutico , Recidiva , Diálise Renal/métodos , Irrigação Terapêutica/efeitos adversos , Irrigação Terapêutica/métodosRESUMO
Com o objetivo de estabelecer a prevalência de uropatógenos responsáveis pela infecção do trato urinário no Hospital São Lucas da PUCRS e avaliar a sensibilidade destes aos antimicrobianos, foram estudadas uroculturas com mais de 10 5UFC/ml, coletadas em junho e dezembro de 1996 e janeiro de 1997 em pacientes atendidos no HSL em sistema de emergência, ambulatório e internação...