Мультидисциплинарный подход к коррекции уремического синдрома у пациентки с ангиомиолипомой почки

Abstract

Abstract Patients with uremic syndrome are at high risk of developing various complications that can lead to fatal consequences. Uremic syndrome usually develops on the background of chronic kidney disease, especially its later stages. However, uremia may also occur as a result of tumor, surgical treatment of which can lead the patient to renoprival state. According to various au- thors, the development of uremic syndrome occurs in 7-10% of patients suffering from kidney tumors. Renal angiomyolipoma is a benign mesenchymal tumor, which accounts for 3% of all tumors of renal parenchyma and 90% of all benign tumors of the kidney. It is known that angiomyoli- poma is characterized by slow growth and the associated asymptomatic course. Present study describes a case of uremic syndrome developed as a result of kidney angiomyo- lipoma in a 32-year-old female patient, who earlier underwent nephrectomy in connection with angiomyolipoma of the contralateral kidney. The computer tomography allowed to reveal a large retroperitoneal space-occupying lesion and to detect a spontaneous rupture of this formation, in connection with which the patient underwent a revision of the retroperitoneal space. While mak- ing the revision of the tumor no kidney authentic tissues were clearly detected. That was the reason for performing the nephrectomy. The patient has begun renal replacement therapy using haemodialysis. The mother of the patient expressed a desire to become a kidney donor for the daughter. As a result of examination in the potential donor a renal artery aneurism was revealed. After examination of the donor and recipient, the patient has successfully undergone living- related kidney transplantation, and the kidney donor – renal artery plasty. Thus, the specialized urological management, haemodialysis as a method of renal replace- ment therapy and the living-related kidney transplantation, concentrated in one center, have given the chance to provide maximal rehabilitation of the patient with the uremic syndrome as well as to prevent fatal complications in the kidney donor.