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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2002  |  Volume : 13  |  Issue : 2  |  Page : 176-180
Missed Renal Infarction Presenting as the Nephrotic Syndrome: A Case Report


1 Department of Medicine, Division of Nephrology, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
2 Department of Radiology, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
3 Department of Surgery, Division of Cardio-thoracic Surgery, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Correspondence Address:
Hassan Abu-Aisha
Department of Medicine (38), King Khalid University Hospital, P.O. Box 2925, Riyadh 11461
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


PMID: 17660658

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Aortic dissection may be associated with renal disease. The presentation, especially in the later stages of the process, includes proteinuria, hematuria and impairment of renal function. Thus the clinical picture may be confused with glomerulonephritis or hypertension. We present a case of ischemic nephropathy resulting from involvement of the right kidney by an aortic dissection. The pateint presented with the nephrotic syndrome some two and a half months after the probable time when the aortic disection had occurred. At that time the initial back and flank pains had disappeared. Ultrasound examination revealed a smaller right kidney, compared to the left one. Imaging techneques, initaited for suspected renal artery stenosis, revealed aortic dissection involving the right renal artery starting from the descending aorta, distal to the origin of the left subclavian artery and extending down to the right common iliac artery; occluding the right renal artery. The medical literature is reviewed for patients presenting with ischemic nephropathy and the mechanisms of proteinuria discussed. We conclude that ischemic nephropathy can clinically mimic glomerulonephritis and can be missed if it is not included in the differential diagnosis of patients who present with heavy proteinuria and hypertension.


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