Korean J Nephrol.
2004 May;23(3):453-458.
Spontaneous Renal Rupture in Patients on Chronic Hemodialysis
- Affiliations
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- 1Department of Internal Medicine, Incheon Sarang Hospital, Incheon, Korea.
- 2Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea.
- 3Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. cmckyo@yahoo.co.kr
- 4Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- 5Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Abstract
- BACKGROUND
Because of high incidence of acquired renal cyst and renal malignancy, it is suggested that spontaneous renal rupture more frequently occurs in patients receiving long-term hemodialysis than general population. This study was performed to evaluate the clinical characteristics of spontaneous renal rupture in hemodialysis patients. METHODS: This retrospective study enrolled 12 hemodialysis patients who developed spontaneous renal rupture. We investigated primary renal disease, duration of dialysis, clinical symptoms and signs, radiologic findings, treatment modalities, and histologic findings. RESULTS: The mean age of the patients was 54+/-10 years old and the number of male was 9. Primary renal disease consisted of autosomal dominant polycystic kidney disease (PCKD) (n=5), chronic glomerulonephritis (n=2), diabetic nephropathy (n=1), hypertensive nephropathy (n=1), unknown cause (n=3). Presenting symptoms and signs were sudden onset of flank pain in 9 patients and gross hematuria with mild flank pain in 3 patients. Mean duration from initiation of hemodialysis to development of spontaneous renal rupture was 53+/-36 months. Abdominal computed tomography showed subcapsular or perinephric hematoma in all patients. Of the 7 non-PCKD patients, 6 patients had multiple acquired renal cysts. Surgical exploration was undertaken in 9 patients. Pathologic examination demonstrated small sized-renal cell carcinoma in 2 of 9 patients. Three patients were only treated with conservative management including blood transfusion. All 12 patients recovered without recurrence. CONCLUSION: This study demonstrated that genetic or acquired renal cyst was an important cause of spontaneous renal rupture in hemodialysis patients and presenting manifestations were sudden onset of flank pain and gross hematuria.
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