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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2009  |  Volume : 20  |  Issue : 1  |  Page : 120-123
Reflex anuria affecting both kidneys following hysterectomy


1 Department of Nephrology, Ekbatan Hospital, Hamedan University of Medical Sciences and Health Services, Hamedan, Iran
2 Sina Hospital, Hamedan University of Medical Sciences and Health Services, Hamedan, Iran
3 Department of Urology, Ekbatan Hospital, Hamedan University of Medical Sciences and Health Services, Hamedan, Iran
4 Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences and Health Services, Zanjan, Iran
5 Faculty of Nursing Department, Islamic Azad University, Birjand Branch, Birjand, Iran

Correspondence Address:
Mahmoud Gholyaf
Department of Nephrology, Hamedan University of Medical Sciences and Health Services, Hamedan
Iran
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PMID: 19112230

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In situations when there is unilateral ureteral obstruction, the contralateral kidney retains its normal function. In rare instances however, it has been reported that unilateral ureteral obstruction can lead to reflex anuria (RA) and acute renal failure (ARF). Even more unusually, RA with ARF can occur without organic obstruction due to ureteric manipulation during pelvic surgery. We report a 78- year-old woman, who underwent hysterectomy because of endometrial carcinoma. She developed ARF evidenced by anuria of 120-hours duration, and gradual rise of serum creatinine levels to 11.8 mg/dL on the fifth day after hysterectomy. Ultrasound study of the urinary tract revealed bilateral moderate hydronephrosis. Detailed evaluation did not reveal any organic obstruc­tion. She was managed with hemodialysis, control of hypertension and correction of fluid and elec­trolyte imbalances. By the sixth day, diuresis was established, and the blood urea and serum crea­tinine levels decreased to normal by the sixteenth day. The patient was finally discharged on the eighteenth day. Our case suggests that urologists and nephrologists should consider RA as one of the causes of anuria and ARF.


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