Nephrol Dial Transplant (2000) 15: 2050-2052
© 2000 European Renal Association-European Dialysis and Transplant Association
Teaching Points
Acute renal failure and paraplegia in a patient with a pelvic-ring fracture
(Section Editor: K. Kühn)
1 Departments of Internal Medicine D, 2 Diagnostic Imaging and 3 Nephrology Meir Hospital Sapir Medical Center, Kfar-Saba and the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Keywords: hydronephrosis; paraplegia; pelvic compartment syndrome; retroperitoneal haematoma
Introduction
Acute renal failure (ARF) is a common sequela of trauma. The major factors responsible for ARF in this setting are hypovolaemic shock, sepsis, and the use of nephrotoxic agents. Pelvic-ring fractures are often associated with injuries of the urinary tract in an incidence of 1240% [13]. They are also normally accompanied by retroperitoneal bleeding [3,4]. The presence of anuria in such cases requires the initial exclusion of injuries to the urethra and/or bladder. Although hypotension-induced acute tubular necrosis (ATN) should be considered, obstructive uropathy due to ureteric or bladder compression by a
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