J Korean Soc Pediatr Nephrol > Volume 17(2); 2013 > Article
J Korean Soc Pediatr Nephrol 2013;17(2): 117-121. doi: https://doi.org/10.3339/jkspn.2013.17.2.117
작은 요로 결석에 의한 급성 신후성 신부전 및 폐쇄 후 이뇨 1례
정의석, 양은미, 김찬종
전남대학교 의과대학 소아청소년과
Acute Kidney Injury and Postobstructive Diuresis Caused by a 4 mm Urinary Calculus
Eui Seok Jung, Eun Mi Yang, Chan Jong Kim
Departments of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
Corresponding Author: Eun Mi Yang ,Tel: 062-220-6647, Fax: 062-222-6103, Email: emyang@chonnam.ac.kr
Received: December 4, 2012;  Accepted: June 9, 2013.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons. org/licenses/bync/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Urinary obstructions from ureteral calculi are one of the causes of postrenal acute kidney injury (AKI). Here we present a case of AKI caused by a 4 mm ureteral calculus with postobstructive diuresis following the spontaneous passage of the calculus. A 13-year-old girl who underwent nephrectomy for the removal of a neuroblastoma eight years previously, visited our institution because anuria had developed over the preceding five days. The serum creatinine level was elevated at 13.4 mg/dL. Radiological examinations showed the right solitary kidney with moderate hydronephrosis and a 4 mm calculus in the upper right ureter. The patient immediately underwent hemodialysis. After the ureteral calculus was passed spontaneously on day 2 of hospitalization, urinary output increased to more than 5,200 mL per day. Intravenous fluid replacement with careful monitoring of weight, intake, output, and serum and urine electrolytes was performed. On day 5 of hospitalization, the patient’s condition stabilized.
Key words: Calculi | Obstruction | Acute kidney injury | Polyuria | Anuria
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