Kidney Pain

OBJECTIVES: Distinguishing between kidney stones and phleboliths can constitute a diagnostic challenge in patients undergoing unenhanced low-dose CT (LDCT) for acute flank pain. We sought to investigate the accuracy of radiomics and a machine-learning classifier in differentiating between kidney stones and phleboliths on LDCT. METHODS: Radiomics features were extracted following a semi-automatic segmentation of kidney stones and phleboliths for two independent consecutive cohorts of patients undergoing LDCT for acute flank pain...

Background: Chronic kidney disease (CKD) patients experience a high symptom burden including fatigue, sleep difficulties, muscle weakness and pain. These symptoms reduce levels of physical function (PF) and activity, and contribute to poor health-related quality of life (HRQoL). Despite the gathering evidence of positive physiological changes following exercise in CKD, there is limited evidence on its effect on self-reported symptom burden, fatigue, HRQoL and physical activity. Methods: Thirty-six patients [mean ± SD 61...

Case summary: A 57-year-old woman with morbid obesity (body mass index [BMI] of 43), systemic lupus on steroids, type 2 insulin-dependent diabetes, peripheral vascular disease, unprovoked pulmonary embolism on rivaroxaban, and hypertension presented with 3 days of worsening abdominal pain and nausea. She had an extensive surgical history including a cesarean section, multiple laparotomies for small bowel obstructions (one complicated by bowel perforation requiring resection), and a double-barrelled ileostomy, which had been since reversed...

OBJECTIVE: To investigate the clinicopathological and immunohistochemical features as well as diagnosis, differential diagnosis,treatment and prognosis of patients with primary renal non-hodgkin's lymphoma (PRNHL). METHODS: Clinical data of 2 patients with PRNHL from January 2013 to October 2017 were retrospectively analyzed. RESULTS: One of the two male patients PRNHL aged 51 years old, admitted to hospital for swelling and pain in the right waist, B-ultra sonic examination showed a very solid upper right renal space occupying lesion...

Comorbidities are common in respiratory disease patients and have been well-known to impact their quality of life. The objective of this study is to estimate the minimal clinically important difference (MCID) of the health-related quality of life (HRQOL) among respiratory disease patients with different comorbidities in a Vietnamese tertiary hospital. We performed a cross-sectional study from October to November 2016 at the Respiratory Center of Bach Mai Hospital, Hanoi, with a total of 508 participants. Information about socio-economic characteristics, HRQOL and comorbidities of participants was collected...

Primary angiosarcomas of the kidney are very rare, but highly aggressive tumors showing poor prognosis. Patients frequently complain of flank pain, hematuria, or a palpable mass. We present a case of primary renal angiosarcoma occurring in a 61-year-old man. CT images depicted a huge exophytic mass (16 cm in diameter) in the right kidney, exhibiting extensive hemorrhage. The mass showed centripetal peripheral nodular enhancement on dynamic contrast-enhanced images. Furthermore, MR imaging revealed a tangled mesh of tumor vessels in the periphery of the mass...

Significant chronic pain is highly prevalent in chronic kidney disease patients and is associated with morbidity and mortality. In this study, we retrospectively evaluated the incidence and treatment of pain in the dialysis unit of our tertiary referral center. The cohort included 147 patients. Over 66% reported significant (VAS >40) chronic pain during the preceding 3 months, most often characterized as stabbing (38%) and with concurrent itching (44%). Only 33% of patients received chronic pain medications, while 55...

RATIONALE: Renal artery aneurysm (RAA) is a rare entity, bilateral multiple RAAs near hilum with a maximum diameter of 7 cm are even rare and bring a great challenge to surgeons. As the technique of vessel reconstruction is quite difficult for the RAAs near hilum, some surgeons choose to resect the involved kidney. We reported a young female patient with the threatened rupture symptoms for further treatment. The details of revascularization methods and procedure design were discussed in the report...

BACKGROUND: There is an unmet need for a safer and more effective treatment for obesity. This study assessed the effects of licogliflozin, a dual inhibitor of sodium-glucose co-transporter (SGLT) 1/2, on body weight, metabolic parameters and incretin hormones in patients with T2DM and/or obesity. METHODS: Patients with obesity (BMI 35-50kg/m2 ) were enrolled into a 12-week study (N=88; licogliflozin 150 mg q.d.). Patients with type-2 diabetes-mellitus (T2DM) were enrolled into a second, two-part study, comprising a single-dose cross-over (N=12; 2...

INTRODUCTION: Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA) syndrome is a rare variant of Müllerian anomalies. Delay in diagnosis and treatment can produce serious complications in patient's life and fertility. The aim of this study is to present our experience in clinical presentation, diagnosis and complications of patients with OHVIRA syndrome in a 20-year period. PATIENTS AND METHODS: Retrospective analysis of 9 women under 25 years old with OHVIRA syndrome between 1997 and 2017...

BACKGROUND Tumor lysis syndrome (TLS) is an oncologic emergency resulting from the massive destruction of tumor cells after cytotoxic chemotherapy for chemosensitive malignancies with a high tumor burden. Its clinical manifestations include severe electrolyte disturbances, metabolic acidosis, acute renal failure secondary to urate deposition in the kidney, heart, and skeletal muscle, and nervous system dysfunction. We report an extremely rare case of spontaneous TLS (STLS) in idiopathic primary myelofibrosis (PMF)...

BACKGROUND: Calciphylaxis is a form of vascular calcification more commonly associated with renal disease. While the exact mechanism of calciphylaxis is poorly understood, most cases are due to end stage kidney disease. However, it can also be found in patients without kidney disease and in such cases is termed non-uremic calciphylaxis for which have multiple proposed etiologies. CASE SUMMARY: We describe a case of a thirty-year-old morbidly obese Caucasian female who had a positive history of alcoholic hepatitis and presented with painful calciphylaxis wounds of the abdomen, hips, and thighs...

Introduction: Calciphylaxis is an infrequent disease that almost exclusively affects patients with chronic kidney disease, although cases have been observed in patients without renal function impairment. The diagnosis is mainly made by clinical manifestations and subsequently confirmed by radiological and histological study. The optimal treatment is not known, although there is a consensus that a multifactorial approach is required. Clinical Case: A 68-year-old woman on hemodialysis for 2 years, who presented a painful nodular lesion in the left thigh, a skin biopsy was performed resulting in a diagnosis of calciphylaxis...

Ileal conduit volvulus is a rare complication of urinary diversion. It has been suggested that various factors including prolonged length of the ileal segment, lack of fixation of the conduit to the peritoneum and failure to close the incised mesentery predispose patients to this complication. We present the case of a 76-year-old man who presented to hospital with severe abdominal pain and oliguria secondary to a volvulus of his ileal conduit. Investigations revealed early acute kidney injury as a result of urinary obstruction which was evident on abdominal CT...

Primary Ewing sarcoma (ES) or primitive neuroectodermal tumour (PNET) is a rare tumour in adults and primary renal involvement is extremely rare. Patients with renal ES or PNET respond to and would benefit from conventional ES treatment according to ES study protocols. Here, we report a case of a young woman, presenting with right flank pain and haematuria. After ultrasound and CT evaluation, a right middle pole renal mass was detected. The patient underwent radical right nephrectomy, and a grade 4 ES with peritoneal involvement was documented...

A 55-years-old Caucasian male presented with chest pain, dyspnea and hypotension four-months after simultaneous liver and kidney transplantation. His post-transplant course was complicated with only one episode of acute cellular rejection one month prior to presentation, successfully treated with steroids. His immunosuppression consisted of tacrolimus and mycophenolic acid. Transthoracic echocardiogram (TTE) in the emergency room showed a large pericardial effusion and tamponade physiology. Emergent pericardiocentesis removed 560 mL of bloody fluid (red blood cell count of 6...

BACKGROUND: Increasing numbers of older adults are living with kidney disease. For those with comorbidities, conservative management of end-stage kidney disease is a viable option: dialysis may afford limited or no survival benefit, and perceived burdens may outweigh benefits. Conservative management focuses on: maintaining remaining kidney function; symptom management; and quality of life. Common symptoms in conservatively managed kidney disease include: fatigue; anorexia; nausea and vomiting; pain and pruritis...

RATIONALE: Collecting duct carcinoma (CDC) is a rare neoplasm arising from the collecting duct and should be distinguished from other renal cell carcinomas that mostly originated from the proximal tubular epithelium and tumors originated from the urothelium. It usually occurs in unilateral kidney, sometimes found with cystic change. PATIENT CONCERNS: We present the case of a 53-year-old male suffering from repeated bilateral flank pain for 6 months, increased pain with dysuria for 5 days...

RATIONALE: Patients with nasal metastases are seldom seen among clear cell renal cell carcinoma (CCRCC). We report a rare case presenting as a solitary nasal cutaneous nodule, and summarize the therapeutic experience of tyrosine kinase inhibitors (TKIs). PATIENT CONCERNS: A 86-year-old man with a chief complaint of continuous back pain for 3 months and discovery of a cutaneous nodule on the nose for a month visited the oncology department of our hospital. Maxillofacial computed tomography (CT) scans demonstrated a 1...

Background: Pregabalin is an anticonvulsant and has been used for postoperative analgesia. This study aimed to assess the effect of a single preoperative dose of pregabalin for analgesia after nephrectomy. Methods: The study was prospective, randomized, comparative, and double-blinded, conducted in 40 kidney transplant donors, between 18 and 60 years, American Society of Anesthesia physical status I or II. Epidural anesthesia was performed with 15 mL of 0.5% ropivacaine single shot and general anesthesia with 3 µg/kg of fentanyl, propofol, atracurium, and sevoflurane, and 50% of oxygen without nitrous oxide...