血液透析により救命し得た急性両側性腎皮質壊死の1例

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タイトル別名
  • BILATERAL RENAL CORTICAL NECROSIS
  • ケツエキ トウセキ ニ ヨリ キュウメイ シエタ キュウセイ リョウガワセイジンヒシツ エシ ノ 1レイ
  • A CASE REPORT OF RECOVERY BY HEMODIALYSIS

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A 29-year-old woman with bilateral renal cortical necrosis following delivery, who was saved by hemodialysis, is reported.<br>The patient was maintained by hemodialysis during a period of 11 days of anuria and oliguria. Following the period, her renal function was improved gradually.<br>Nine months after the onset of her illness, the serum BUN was 32mg/dl, the twenty-four hour creatinine clearance was 13l/day, and the patient was feeling well.<br>It is generally accepted that bilateral renal cortical necrosis, which itself is of rare entity, has an almost universally fatal outcome because of its irreversible lesion, and that the survival case is extremely uncommon.<br>So far, there have been only 19 reported survivors among English and German literatures.<br>In Japan, 13 autopsy cases have been reported but none with survival.<br>Some discussions regarding pathogenesis of the bilateral renal cortical necrosis especially that of the disseminated intra-vascular coagulation mechanism were done.<br>Clinical analysis of the 15 survived cases reported in the literatures revealed that; 1) improvement of the renal function in the survivors could be expected up to 12 months after onset of the illness, 2) the longer the period of anuria and oliguria, the worse the renal function, 3) the cases, in which hypertension were noticed in their courses, had poorer prognosis than the normotensive group.

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