DEVELOPMENT OF SPONTANEOUS RENAL HEMORRHAGE ASSOCIATED WITH ACUTE PANCREATITIS IN A PATIENT ON HEMODIALYSIS FOR CHRONIC RENAL FAILURE: A CASE REPORT

YA-WEI CHEN¹, WEN-JU SHI¹, YU-PENG LI², XIU-MEI GAO¹, MEI-YAN ZHANG¹, GUANG-LI REN¹

¹Nephrology Department of Chinese PLA 254 Hospital, Tianjin, China - ²Tianjin Medical University, Metabolic Disease Hospital and Tianjin Endocrinology Institute, No.66, TongAn Road, Heping District, Tianjin, China

Objective: We present one rare case of spontaneous renal hemorrhage(SRH) in a 32-year-old woman with systemic lupus erythematosus(SLE) undergoing maintenance HD, and she subsequently developed acute pancreatitis(AP). These complicated illnes- ses she suffered brings us into question whether there is a causal relationship between SHR and AP in HD patient.

Methods: A CT scan of the abdomen supported the evidence of renal hemorrhage.In view of the markedly raised pancreatic enzymes and CT findings, the acute pancreatitis was also diagnosed.

Results: Multi-factors lead to the development of the disease. The factors such as anticoagulation used during HD, uraemia- associated functional platelet abnormalities, immunosuppression (corticosteroid), intimal arterial fibrosis and hypertension often combine to cause SRH. Other possibilities can be considered for the mechanism of AP: SHPT, gastrointestinal hormones and immu- nological condition.

Conclusion: SRH and AP are both potentially life threatening condition in patients with end-stage renal disease(ESRD). A detailed understanding of pathophysiological processes and immunological aspects in patients is the basis for the development of therapeutic strategies that will provide significant reductions in morbidity and mortality.