Kidney Week

Abstract: FR-PO0999

A Rare Case of Kidney Failure Due to Deeply Infiltrating Endometriosis and Nonsteroidal Anti-Inflammatory Drug Use

Session Information

• Women's Health and Kidney Diseases
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Women's Health and Kidney Diseases

• 2100 Women's Health and Kidney Diseases

Authors

• Szamosfalvi, Kata, NYU Langone Health, New York, New York, United States

Kata Szamosfalvi, MD

• Ojukwu Perdomo, Tommy, NYU Langone Health, New York, New York, United States

Tommy Ojukwu Perdomo, MD

• Ali, Syed, NYU Langone Health, New York, New York, United States

Syed Ali, DO

• Marinis, Jenna, NYU Langone Health, New York, New York, United States

Jenna Marinis, MD

• Chawla, Harminder S., NYU Langone Health, New York, New York, United States

Harminder S. Chawla, MD

• Begum, Papiya, NYU Langone Health, New York, New York, United States

Papiya Begum, MD

Introduction

Less than 1% endometriosis cases involve the urinary tract; correlation is increased with deeply infiltrating endometriosis (DIE). Chronic pelvic pain in endometriosis is treated similarly to dysmenorrhea with NSAIDs. This report aims to highlight a rare cause of chronic kidney disease and kidney failure in reproductive age female patients, discuss management and highlight the importance of preventive counseling.

Case Description

A 31-year-old female with PMH of DIE complicated by obstructive uropathy requiring ureteral stenting, CKD G4 presented to the hospital with abdominal pain, nausea and vomiting after medical termination of pregnancy. She completed leuprolide therapy of endometriosis two months prior and had worsened abdominal pain afterwards, prompting NSAID use exceeding 3 g daily. She denied fevers, chills, dysuria, or hematuria. On examination, BP 128/84, HR 87, RR 16, SpO2 100% on room air, T 36.7 C; clear lung sounds, no edema or abdominal tenderness. Laboratory studies revealed WBC 12.3, Cr 8.19, HCO3 13, AG 22, pH on VBG 7.07 with low lactate, phos 5.2. UA notable for 300 protein, >100 RBC and WBC, E. coli bacteriuria and 0-2 casts. Pelvic US showed no retained products of conception; CT imaging demonstrated right kidney atrophy without hydronephrosis. She was admitted for kidney failure due to NSAID use and volume depletion requiring KRT, with improvement in kidney function. She was discharged with no immediate need for KRT, counseled to avoid NSAIDs, and referred to OBGYN for her DIE.

Discussion

CKD management follows guidelines aimed at addressing the underlying causes, correcting fluid or electrolyte balance disturbances, and preserving kidney function. History of medications and comorbidities can identify contributing factors to kidney failure. In patients with CKD due to DIE, stenting relieves obstructive uropathy, while treating endometriosis with surgical or hormonal interventions. Management requires shared decision-making regarding risks to fertility. Renal failure carries a poor prognosis and reduced life expectancy. Patients with CKD related to endometriosis have increased risks for deterioration of kidney function from both structural changes and NSAID use. Interdisciplinary management with a multimodal approach, preventive counseling and safe pain management are vital for staving off kidney failure and prolonging survival.