Korean J Pathol.  1997 Mar;31(3):263-268.

Acute Renal Failure Associated with Gross Hematuria in a Patient with Focal Glomerulonephritis

• Kim HJ
• Jeong HJ
• Han DS

Abstract

A 58-year-old female with an episode of gross hematuria two months before and fever and chill for the past three days presented oliguric acute renal failure. She has taken NSAID intermittently for 18 years due to rheumatoid arthritis, and herb medicine for one week two months ago when gross hematuria developed. Physical examination revealed mild tenderness on costovertebral angles. Her blood pressure was 170/100 mmHg, the urinalysis showed >300 mg protein with many RBCs and 10-20 WBCs and the serum creatinine was 5.8 mg/dl. A renal biopsy performed on the 4th hospital day showed that it was overwhelmed by severe tubular lesions which reveal intratubular obstruction by massive erythrocyte casts and tubular necrosis. The glomeruli showed focal minimal crescents with many red blood cells entrapped in the crescents and in the capillaries. Immune deposits were not present. A renal failure resolved spontaneously and the patient was discharged three weeks later with creatinine of 2.4 mg/dl. In this patient, acute renal failure was considered to be due to a tubular lesion related to the glomerular bleeding from focal glomerulonephritis revealing minimal crescents.

Keyword

acute renal failure; glomerulonephritis; gross hematuria

MeSH Terms

Acute Kidney Injury*
Arthritis, Rheumatoid
Biopsy
Blood Pressure
Capillaries
Creatinine
Erythrocytes
Female
Fever
Glomerulonephritis*
Hematuria*
Hemorrhage
Humans
Middle Aged
Necrosis
Physical Examination
Renal Insufficiency
Urinalysis
Creatinine