Two Cases of Patchy Renal Vasoconstriction without Antecedent Anaerobic Exercise

Kim, Hee Sung; Yoon, Su In; Cheoi, Kyung Suck; Joung, Ki Ok; Kwon, Soon Kil; Kim, Hye Young

Abstract

Patchy renal vasoconstriction is one of the reversible renal vasoconstrictions, which usually occur in healthy young men following strenuous anaerobic exercise. Analgesics, viral infection, dehydration were known to be the causes of patchy renal vasoconstriction. We experienced two cases of patchy renal vasoconstriction without antecedent anaerobic exercise. The first case is a 54-year-old woman admitted to a hospital with severe loin pain. On admission, serum creatinine was elevated to 2.2 mg/dL. Patchy areas of delayed contrast enhancement in both kidneys were observed on immediate post-contrast CT and 14 hours delayed image. This severe loin pain was initiated without anaerobic exercise. On the 4th day, her loin pain was relieved and on the 12th day of her illness, serum creatinine was normalized with supportive care. The second case is an 18- year-old man presented with pain in the both flanks. Five days earlier, operation had been performed for treatment of gynecomastia. There had been no preceding anaerobic exercise before the flank pain occurred. On admission to the hospital, laboratory studies revealed a serum creatinine 2.3 mg/dL. Computed tomography showed multiple patchy areas of enhancement in the renal parenchyma. On 12 hours delayed image, there were delayed contrast enhancement. On the sixth day, serum creatinine decreased to 1.4 mg/dl and the loin pain was subsided. Patchy renal vasoconstriction can occur without exercise, and we suggest that patchy renal vasoconstriction should be suspected in the patients suffering from acute renal failure with severe loin pain even without strenuous exercise.