ESPN 50th Annual Meeting

ESPN 2017


 
A rare cause of post-renal acute kidney injury by neuroblastoma and a role of pediatric nephrogist in percutaneously performed bilateral nephrostomy.
CANER ALPARSLAN 1 BELDE KASAP DEMIR 2 FATMA MUTLUBAŞ 1 ÖNDER YAVAŞCAN 1 SEÇIL ARSLANSOYU ÇAMLAR 1 ELIF PERIHAN ÖNCEL 3 EREN SOYALTIN 1 DEMET ALAYGUT 1

1- IZMIR TEPECIK TRAINING AND RESEARCH HOSPITAL, PEDIATRIC NEPHROLOGY
2- IZMIR KATIP CELEBI UNIVERSITY, PEDIATRIC NEPHROLOGY
3- IZMIR TEPECIK TRAINING AND RESEARCH HOSPITAL, PEDIATRICS
 
Introduction:

Acute kidney injury is mostly caused by pre-renal pathologies, therefore renal and post-renal causes are less common. In this case, we wanted to share our experience about the role of bilaterally performed percutaneous nephrostomy by pediatric nephrologists in management of post-renal AKI secondary to neuroblastoma.

Material and methods:

Case report

Results:

8-month year-old male baby was reffered to our hospital with complaints of watery defecation, vomiting for 3-4 days and refusing to feeding in last 24 hours. In physical examination: body weight 8.2kg(25-50p), height 71cm (25-50p), body temperature 36.80C, respiratory rate 60/min, heart rate 140/min, blood pressure (87/55mmHg) (95p:85 mmHg/95p: 53mmHg), sO2 %94, bilateral +2 edema in lower exremities and solid mass palpated in whole abdomen. In laboratuvary: urea 164 mg/dL, creatinine 10.3 mg/dL, potassium 5.54 mmol/L, sodium 132 mmol/L, calsium 10 mg/dL, phosphorus 6.6 mg/dL, uric acid 13.2 mg/dL, hemoglobine 8.8 g/dL, white blood cell 21.000/uL, platellets 492.000 /uL, INR 1.06 (N:0.94-1.28), aPTT 27.5 sec, PT 13.5 sec, blood pH 7.0, bicorbanoate 3.7 mmol/L, lactat 2.3, base excess -21. In renal ultrasonography, bilateral hydronephrosis and reduced parenchymal thickness was detected. Ureters were covered by soft tissue mass located between superior mesenteric artery and iliac bifurcation in abdominal CT. Double J catheters can not be advace in renal pelvis in cystoscophy. Ultrasound guided bilateral 8F percutaneous nephrostomy catheters were placed by pediatric nephrologist. Hemodiafiltration treatment was commenced on due to hypervolemia and hypertension. In following 48 hours, there was no need for dialysis. Neuroblastoma diagnosis was made in histologic specimens. After completion of chemotherapy and surgical course, the patient has normal kidney funcitons and normal ultrasonographic examination.

Conclusions:

Intraabdominal masses should be kept in mind in post-renal AKI etiologies. We advocate that ability to perform nephrostomy by pediatric nephrologist has a critical importance in kidney and patient survival.