Abstract
Reversible acute kidney injury very rarely complicates the course of immunoglobulin A (IgA) nephropathy. We report an atypical case of reversible acute kidney injury, gross hematuria, and severe bilateral flank pain as the presenting triad of IgA nephropathy. Renal biopsy revealed mesangial IgA deposition without glomerular crescents. The patient’s renal dysfunction, mediated by red cell tubular obstruction, interstitial nephritis, and tubular necrosis, resolved without intervention. We conclude that IgA nephropathy should be considered in the differential diagnosis for transient acute kidney injury with gross hematuria, and should be appropriately treated based on known prognostic factors.
References
Lui SL, Chan KW, Chan TM, Cheng IKP. Reversible acute renal failure in a patient with IgA nephropathy. HKMJ. 1995;1:351–3.
Wen YK, Chen ML. The spectrum of acute renal failure in IgA nephropathy. Ren Fail. 2010;32(4):428–33.
Lee HS, Pyo HJ, Koh HI. Acute renal failure associated with hematuria in IgA nephropathy. Am J Kidney Dis. 1988;12(3):236–9.
Fogazzi GB, Imbasciati E, Moroni G, Scalia A, Mihatsch MJ, Ponticelli C. Reversible acute renal failure from gross haematuria due to glomerulonephritis: not only in IgA nephropathy and not associated with intratubular obstruction. Nephrol Dial Transplant. 1995;10(5):624–9.
Praga M, Gutierrez-Millet V, Navas JJ, Ruilope LM, Morales JM, Alcazar JM, et al. Acute worsening of renal function during episodes of macroscopic hematuria in IgA nephropathy. Kidney Int. 1985;28:69–74.
Lupo A, Rugiu C, Cagnoli L, Zucchelli P, Maschio G. Acute changes in renal function in IgA nephropathy. Semin Nephrol. 1987;7:356–62.
Gutiérrez E, González E, Hernández E, Morales E, Martínez MA, Usera G, et al. Factors that determine an incomplete recovery of renal function in macrohematuria-induced acute renal failure of IgA nephropathy. Clin J Am Soc Nephrol. 2007;2(1):51–7.
Delclaux C, Jacquot C, Callard P, Kleinknecht D. Acute reversible renal failure with macroscopic haematuria in IgA nephropathy. Nephrol Dial Transplant. 1993;8(3):195–9.
D’Amico G, Napodano P, Ferrario F, Rastaldi MP, Arrigo G. Idiopathic IgA nephropathy with segmental necrotizing lesions of the capillary wall. Kidney Int. 2001;59(2):682–92.
Nolin L, Courteau M. Management of IgA nephropathy: evidence-based recommendations. Kidney Int Suppl. 1999;70:S56–62.
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All the authors have declared no competing interests.
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Kim, S., Chang, W. Atypical triad of IgA nephropathy: reversible acute kidney injury, gross hematuria, and severe bilateral flank pain. CEN Case Rep 3, 145–147 (2014). https://doi.org/10.1007/s13730-013-0106-x
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DOI: https://doi.org/10.1007/s13730-013-0106-x