급성 신우신염에 합병된 급성 신부전증 2예
Two cases of acute renal failure secondary to acute pyelonephritis
소속 상세정보
박삼석/Sam Seok Park
배우형/김도훈/송상헌/정현철/이우철/이수봉/곽임수/나하연/Woo Hyung Bae/Do Hoon Kim/Sang Heun Song/Hyun Chul Jung/Woo Chun Lee/Soo Bong Lee/Ihm Soo Kwak/Ha Yeon Rha
KMID : 0882420010600030254
Abstract
급성 신우신염에서 드물게 급성 신부전증이 합병될 수 있으므로 급성 신부전증의 감별진단에서 고려되어야 하며 특히 고령에서는 감염 증상이 특징적이지 않은 경우가 많아 쉽게 놓칠 수 있어 각별한 주의가 필요하다. 저자들은 고령에서 급성 신우신염에 합병된
급성
신부전증을 조기 발견 후 즉각적이고 적합한 항생제 치료 등 보존적 치료로 완전 회복된 2예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다
Acute renal failure secondary to acute pyelonephritis is developed rarely. But acute pyelonephritis is considered in differential diagnosis of acute renal failure, particularly in elderly patient. Elderly patient showed subtle symptoms or signs
of
infections and can be missed easily. We experienced two cases of acute renal failure secondary to acute pyelonephritis. In first case, one patient complained fever, chilling and right flank pain for 10 days. Three repeated blood and urine
cultures
showed E. coli, respectively. At admission serum creatinine showed 2.4 mg/dL and thereafter increased to 4.5 mg/dL, and then decreased to 1.7 mg/dL with antibiotic therapy and hydration at 14 days of admission. In second case, patient complained
right
flank pain, costovertebral tenderness and urinary difficulty at admission. Two repeated blood culture showed no growth, two repeated urine culture showed > 105 ml/dL of E. coli. At admission serum creatinine level was 2.69 mg/dL and then
decreased
to
1.7 mg/dL with antibiotic therapy and hydration at 14 days of admission.
Acute pyelonephritis should be considered in differential diagnosis of acute renal failure in the elder ages, although this developed rarely. Early recognition and appropriate antibiotic treatment helps recover acute renal failure secondary to
acute
pyelonephritis.
키워드
Acute pyelonephritis; Acute renal failure;
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