Acute kidney injury due to retroperitoneal fibrosis: complexities of diagnosis and treatment
- Authors: Vetchinnikova O.N.1, Suslov V.P.1, Stepanova E.A.1, Dutov V.V.1
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Affiliations:
- GBUZ Moscow district “Moscow Regional Research Clinical Institute named after M.F. Vladimirsky
- Issue: No 1 (2025)
- Pages: 84-88
- Section: Clinical case
- URL: https://journals.rcsi.science/1728-2985/article/view/314220
- ID: 314220
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Abstract
Retroperitoneal fibrosis (RPF) is a rare cause of postrenal acute kidney injury (AKI). We present a clinical case of a 65-year-old patient who developed acute right-sided hydronephrosis with postrenal AKI. Contrast-enhanced computed tomography showed dilation of the ureter, pelvis and calyxes on the right, diminished size of the left kidney and signs of RPF, including fat tissue thickening, compaction and stranding along the aorta and its visceral branches, mesenteric sinuses, thickening of the peritoneum at the level of the paracolic gutters, pelvic tissue compaction, descending and infrarenal abdominal aortic aneurisms, subocclusion of the left renal artery, and atherosclerosis of the visceral arteries. The patient received hemodialysis. IgG4-related RPF was diagnosed. A 6Ch/24 cm stent was placed in the right ureter, after that AKI resolved. Patients with RPF require multidisciplinary approach for timely diagnosis and successful treatment.
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##article.viewOnOriginalSite##About the authors
Olga N. Vetchinnikova
GBUZ Moscow district “Moscow Regional Research Clinical Institute named after M.F. Vladimirsky
Author for correspondence.
Email: olg-vetchinnikova@yandex.ru
ORCID iD: 0000-0002-1888-8090
Ph.D., MD, Associate professor of Kidney Transplantation Department
Russian Federation, 61/2 Shchepkina str., Moscow 129110Vladimir P. Suslov
GBUZ Moscow district “Moscow Regional Research Clinical Institute named after M.F. Vladimirsky
Email: vpsuslov@mail.ru
ORCID iD: 0009-0002-8347-6022
Ph.D., Head of dialysis department
Russian Federation, 61/2 Shchepkina str., Moscow 129110Elena A. Stepanova
GBUZ Moscow district “Moscow Regional Research Clinical Institute named after M.F. Vladimirsky
Email: stepanovamoniki@gmail.com
ORCID iD: 0000-0002-9037-0034
Ph.D., Head of the Division of Radiation Diagnostics, Associate Professor of Radiation Diagnostics in Faculty of Postgraduate Medical State Institution
Russian Federation, 61/2 Shchepkina str., Moscow 129110Valery V. Dutov
GBUZ Moscow district “Moscow Regional Research Clinical Institute named after M.F. Vladimirsky
Email: valeriy.dutov.52@mail.ru
ORCID iD: 0000-0003-3539-441X
Ph.D., MD, professor, leading researcher, Head of Department of Urology
Russian Federation, 61/2 Shchepkina str., Moscow 129110References
- Albarran J. Rétention rénale par périurétérite. Libértion externe de l’uretére. Assoc. Fr. Urol 1905;9:511–517.
- Ormond J.K. Bilateral ureteral obstruction due to envelopment and compression by an inflamatory retroperitoneal process. J Urol. 1948;59(6):1072–1079. doi: 10.1016/s0022-5347(17)69482-5
- Łoń I., Wieliczko M., Lewandowski J. et al. Retroperitoneal Fibrosis Is Still an Underdiagnosed Entity with Poor Prognosis. Kidney Blood Press Res 2022;47(3):151–162. doi: 10.1159/000521423
- Choi Y.K., Yang J.H., Ahn S.Y. et al. Retroperitoneal fibrosis in the era of immunoglobulin G4-related disease. Kidney Res Clin Pract 2019;38(1):42–48. doi: 10.23876/j.krcp.18.0052.
- Korzhavina A.Yu., Fomina N.V., Chesnokova L.D. et al. Difficulties in diagnosing ormond’s disease (retroperitoneal fibrosis). Siberian Medical Review 2023;(2):101–106. [In Russian]. doi: 10.20333/25000136-2023-2-101-106. Russian (Коржавина А.Ю., Фомина Н.В., Чеснокова Л.Д. и соавт. Трудности диагностики болезни Ормонда (ретроперитонеального фиброза). Сибирское медицинское обозрение. 2023;(2):101–106. doi: 10.20333/25000136-2023-2-101-106)
- Zhang W., Stone J.H. Management of IgG4-related disease. Lancet Rheumatol 2019;1:e55–65. doi: 10.1016/S2665-9913(19)30017-7.
- Okpii E., Okpii K., Adamu-Biu F. Bilateral Ureteric Obstruction Due to Retroperitoneal Fibrosis: A Case Report. Cureus 202219;14(8):e28187. doi: 10.7759/cureus.28187.
- Hodson D.Z., Cantley L.G., Perincheri S., Singh N. Perianeurysmal retroperitoneal fibrosis presenting as acute kidney injury: A case report. Clin Nephrol 2021;96(2):112–119. doi: 10.5414/CN110331.
- Rudnev A.O., Maxim M.N., Vizhgorodsky V.B., Kiryushin A.V., Kotans S.Ya. The role of computed tomography in the diagnosis of retroperitoneal fibrosis. Research’n Practical Medicine Journal (Issled. prakt. med.) 2018;5(2):141–147. doi: 10.17709/2409-2231-2018-5-2-15. Russian (Руднев А.О., Максим М.Н., Вижгородский В.Б., Кирюшин А.В., Котанс С.Я. Роль компьютерной томографии в диагностике ретроперитонеального фиброза. Исследования и практика в медицине. 2018;5(2):141–147. doi: 10.17709/2409-2231-2018-5-2-15)
- Wallace Z.S., Naden R.P., Chari S. et al. The 2019 American College of Rheumatology/European League Against Rheumatism Classification Criteria for IgG4-Related Disease. Arthritis Rheumatol 2020;72(1):7–19. doi: 10.1002/art.41120.
- Khosroshahi A., Wallace Z.S., Crowe J.L. et al. Second International Symposium on IgG4-Related Disease. International consensus guidance statement on the management and treatment of IgG4-related disease. Arthritis Rheumatol 2015;67:1688–1699. doi: 10.1002/art.39132.
- Skryabina E.N., Magdeeva N.A., Badurgov I.S. Retroperitoneal fibrosis (ormond’s disease). Clinical case. The Russian Archives of Internal Medicine. 2019;9(2):140–144. doi: 10.20514/2226-6704-2019-9-2-140-144. Russian. (Скрябина Е.Н., Магдеева Н.А., Бадургов И.С. Ретроперитонеальный фиброз (болезнь Ормонда). Клиническое наблюдение. Архивъ внутренней медицины 2019;9(2):140–144. doi: 10.20514/2226-6704-2019-9-2-140-144)
- Shchekaturov S.V., Kaabak M.M., Zokoev A.K. et al. A clinical case of idiopathic retroperitoneal fibrosis. Clinical and Experimental Surgery Journal named after Academician B.V. Petrovsky. 2020;8(1):101–107. doi: 10.33029/2308-1198-2020-8-1-101-107. Russian (Щекатуров С.В., Каабак М.М., Зокоев А.К. и соавт. Клинический случай идиопатического ретроперитонеального фиброза. Клиническая и экспериментальная хирургия Журнал им. академика Б.В. Петровского. 2020;8(1):101–107. doi: 10.33029/2308-1198-2020-8-1-101-107)
- Wallace Z.S., Zhang Y., Perugino C.A. et al. Clinical phenotypes of IgG4-related disease: an analysis of two international cross-sectional cohorts. Ann Rheum Dis 2019;78(3):406–412. doi: 10.1136/annrheumdis-2018-214603.
- Sokol E.V., Cherkasova M.V., Torgashina A.V. The diagnostic value of serum IgG4 for the diagnosis of IgG4-related disease: and is that so great? Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2019;13(1):52–57. doi: 10.14412/1996-7012-2019-1-52-57. Russian (Сокол Е.В., Черкасова М.В., Торгашина А.В. Диагностическая ценность IgG4 сыворотки крови при IgG4-связанном заболевании: так ли она велика? Современная ревматология. 2019;13(1):52–57. doi: 10.14412/1996-7012-2019-1-52-57).
- Hao M., Liu M., Fan G., Yang X., Li J. Diagnostic Value of Serum IgG4 for IgG4-Related Disease: a PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2016; 95:e3785. doi: 10.1097/MD.0000000000003785.
- Maritati F., Rocco R., Accorsi Buttini E. et al. Clinical and prognostic significance of serum IgG4 in chronic periaortitis. An analysis of 113 patients. Front. Immunol. 2019;10:693. doi: 10.3389/fimmu.2019.00693.
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