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

The 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 (N...

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Bibliographic Details
Published in:Internal Medicine 2021/01/15, Vol.60(2), pp.293-298
Main Authors: Odajima, Kohei, Togashi, Ryo, Nemoto, Yoshikazu, Hayama, Yuto, Asakawa, Shinichiro, Nagura, Michito, Arai, Shigeyuki, Yamazaki, Osamu, Tamura, Yoshifuru, Mochizuki, Makoto, Ohashi, Ryuji, Shibata, Shigeru, Fujigaki, Yoshihide
Format: Article
Language:English
Subjects:
acute kidney injury
Acute Kidney Injury - diagnosis
Acute Kidney Injury - etiology
Adult
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Antibiotics
Biopsy
Case Report
Enlargement
Fever
Humans
Inflammation
Internal medicine
Kidney
kidney enlargement
Kidneys
Literature reviews
Male
Nausea
nonsteroidal anti-inflammatory drug
Nonsteroidal anti-inflammatory drugs
Pyelonephritis
Pyelonephritis - complications
Pyelonephritis - diagnosis
Pyuria
Risk factors
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Summary:The 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.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.5721-20