Abstract
A 24-year-old man was admitted to our hospital for persistent proteinuria. He was born with a low birth weight but had grown up uneventful until the age of 20 when he was found to have proteinuria. Because his body mass index was 30.9 kg/m2 at that time, he was diagnosed as obesity-related nephropathy. However, weight reduction and administration of ACE inhibitor were minimally effective for the amelioration of proteinuria. Ultrasound-guided percutaneous renal biopsy at the lower pole of right kidney was performed. As serious bleeding occurred from the right aberrant renal artery soon after biopsy, he was treated with transarterial embolization (TAE). The day after TAE, proteinuria completely disappeared. Renal biopsy showed benign nephrosclerosis with secondary focal segmental glomerulosclerosis (FSGS). Proteinuria could be induced by increased blood flow and pressure due to abnormal blood supply from aberrant renal artery. This is the first report of resolution of proteinuria after TAE of aberrant renal artery in a patient with FSGS.
This is a preview of subscription content, log in via an institution to check access.
References
Gesualdo L, Cormio L, Stallone G, Infante B, Di Palma AM, Delli Carri P, Cignarelli M, Lamacchia O, Iannaccone S, Di Paolo S, Morrone L, Aucella F, Carrieri G. Percutaneous ultrasound-guided renal biopsy in supine antero-lateral position: a new approach for obese and non-obese patients. Nephrol Dial Transplant. 2008;23:971–6.
Zhang Q, Ji Y, He T, Wang J. Ultrasound-guided percutaneous renal biopsy-induced accessory renal artery bleeding in an amyloidosis patient. Diagn Pathol. 2012;7:176.
Chung S, Koh ES, Kim SJ, Yoon HE, Park CW, Chang YS, Shin SJ. Safety and tissue yield for percutaneous native kidney biopsy according to practitioner and ultrasound technique. BMC Nephrol. 2014;15:96.
Whittier WL, Korbet SM. Renal biopsy: update. Curr Opin Nephrol Hypertens. 2004;13:661–5.
Whittier WL. Complications of the percutaneous kidney biopsy. Adv Chronic Kidney Dis. 2012;19:179–87.
Golay V, Roychowdhury A. The percutaneous native kidney biopsy: a nephrologist’s perspective. OA Nephrol. 2013;1:8.
Merklin RJ, Michels NA. The variant renal and suprarenal blood supply with data on the inferior phrenic, ureteral and gonadal arteries: a statistical analysis based on 185 dissections and review of the literature. J Int Coll Surg. 1958;29:41–76.
Khamanarong K, Prachaney P, Utraravichien A, Tong-Un T, Sripaoraya K. Anatomy of renal arterial supply. Clin Anat. 2004;17:334–6.
Özkan U, Oğuzkurt L, Tercan F, Kizilkiliç O, Koç Z, Koca N. Renal artery origins and variations: angiographic evaluation of 855 consecutive patients. Diagn Interv Radiol. 2006;12:183–6.
D’Agati VD, Kaskel FJ, Falk RJ. Focal segmental glomerulosclerosis. N Engl J Med. 2011;365:2398–411.
D’Agati VD. The spectrum of focal segmental glomerulosclerosis: new insights. Curr Opin Nephrol Hypertens. 2008;17:271–81.
Wiggins RC. The spectrum of podocytopathies: a unifying view of glomerular diseases. Kidney Int. 2007;71:1205–14.
Rennke HG, Klein PS. Pathogenesis and significance of nonprimary focal and segmental glomerulosclerosis. Am J Kidney Dis. 1989;13:443–56.
D’Agati VD, Fogo AB, Bruijn JA, Jennette JC. Pathologic classification of focal segmental glomerulosclerosis: a working proposal. Am J Kidney Dis. 2004;43:368–82.
Conflict of interest
There is no conflict of interest statement for all authors.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Harada, K., Tsukahara, J., Kasahara, Y. et al. Resolution of proteinuria after transarterial embolization of aberrant renal artery in a patient with focal segmental glomerulosclerosis. CEN Case Rep 4, 145–150 (2015). https://doi.org/10.1007/s13730-014-0156-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13730-014-0156-8