Abstract: TH-PO814
Nephropathy of Prematurity and the Crucial Role of Kidney Biopsy
Session Information
- Pathology and Lab Medicine - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pathology and Lab Medicine
- 1800 Pathology and Lab Medicine
Authors
- AL Wahadneh, Mohammad, Rochester Regional Health, Rochester, New York, United States
- Dahhan, Hadi, Plainview Hospital, Plainview, New York, United States
- Ravi, Divya, Rochester Regional Health, Rochester, New York, United States
- Dahhan, Ala, Rochester Regional Health, Rochester, New York, United States
Introduction
Nephrogenesis, the creation of nephrons, typically concludes before birth, yet in preterm infants it can extend up to 40 days post-birth. Nevertheless, these late-forming nephrons mature prematurely and remain abnormal. The exact influence of premature birth on nephrogenesis remains unclear. In light of this, we share a case of a young woman with signs of nephropathy attributed to her premature birth.
Case Description
A 22-year-old female with migraines and high blood pressure (230/150 mmHg) presented at an emergency department. Initial tests revealed normal CBC and CMP, but with elevated BUN (62 mg/dL) and creatinine (2.8 mg/dL). Mild proteinuria and a few red blood cells were noted. A renal ultrasound only found a small cyst in the right kidney. No stenosis was found, leading to further diagnostic workup. By the 5th day, with improved kidney function and controlled blood pressure, a renal biopsy was performed due to unclear AKI cause. The biopsy findings indicated acute tubular injury and Glomerulomegaly with secondary focal global and segmental glomerular sclerosis (Figures 1, 2). As the patient had no history of drug abuse, the prospect of premature birth was considered, which she confirmed, leading to the diagnosis of Chronic Kidney Disease due to nephropathy of prematurity
Discussion
This case is unique due to hypertension and renal failure in a patient with a normal workup and kidney size. Nephropathy of prematurity should be considered in young adults presenting with renal failure and benign urinary findings. This case underlines the importance of vigilant follow-ups for early detection of renal diseases in young adults with proteinuria and high blood pressure but normal kidney size. The case raises the question of whether monitoring renal function in premature infants should be extended into adulthood. Kidney biopsy remains the definitive method for diagnosing unexplained CKD, emphasizing the role of vigilant follow-ups and consideration of underlying renal disease in young adults with proteinuria, high blood pressure, and normal kidney size.
Dilated flat tubules and glomerulomegaly. Rare focal scarring
no electron-dense deposits.