1,720,978 research outputs found
Valutazione economica di imprese complesse in contesti complessi. Considerazioni di metodo, criticità, problemi aperti
No full text
La formulazione delle prospettive di risanamento e degli interventi correttivi (Parte 4, 4.1, 4.2, 4.3, 4.4, Appendice B Processo del valore aziendale in crisi)
No full textReflex anuria from unilateral ureteral obstruction
No full textRenal function is usually normal or only marginally affected in patients
with unilateral ureteral obstruction due to the vicarious function of the
contralateral kidney. Few reports exist in which unilateral renal
obstruction is associated with anuria (reflex anuria, RA) and acute renal
failure. We report the clinical case of a female patient who was referred
to the emergency department due to anuria of 72 h duration and acute renal
failure (serum creatinine 9 mg/dl) associated with several episodes of
violent right flank pain with hematuria following extracorporeal shock wave
lithotripsy (ESWL). A few weeks before ESWL, urography showed a 2-cm stone
located in the right pelvis whilst the left kidney was functionally normal.
On admission, renal ultrasound documented a normal left kidney, whilst the
right pelvis was hydronephrotic and there were two indwelling stones at the
right pyeloureteral junction. After the patient passed a urinary stone,
diuresis restarted and acute renal failure was resolved. Thereafter,
urography confirmed that the left kidney, the left ureter and bladder were
functionally and morphologically normal. RA with acute renal failure has
been so scarcely documented that it is considered to be legend by many
clinicians. Major textbooks do not discuss RA with acute renal failure.
Vascular or ureteral spasm related in part to a peculiar hyperexcitability
of the autonomic nervous system may explain RA. We suggest that
nephrologists should always consider RA when evaluating acute renal
failure. On the other hand, RA might be relatively common and we cannot
rule out that only the most severe and/or better-documented cases have been
reported in the medical literature
- …
