Acute kidney injury due to retroperitoneal fibrosis: complexities of diagnosis and treatment

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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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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 129110

Vladimir 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 129110

Elena 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 129110

Valery 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 129110

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