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논문분류	춘계학술대회 초록집
제목	Two Cases of Spontaneous Renal Hemorrhage in Hemodialysis Patients
저자	Boram CHA, *Moon-jae KIM
출판정보	2017; 2017(1):
키워드	Spontaneous Renal Ruputre • Hemodialysis
초록	Objectives : Bleeding is highly likely to occur to dialysis patients and even some clinicians experience many cases of spontaneous hemorrhage. The following cases especially demonstrate spontaneous renal hemorrhage in hemodialysis patients. Methods : Two hemodialysis patients admitted to our hospital with a complaint of abdominal pain without history of trauma. Results : Case 1: A 59 year-old female who had received hemodialysis for 15 years complained with a sudden right abdominal pain. She had a history of renal failure due to hypertension. Initial vital sign was 230/110 mmHg, heart rate 76/min, respiratory rate 22/min, body temperature 37.8 Celsius. Abdominal pelvis computed tomography showed right perirenal hemorrhage. Her laboratory data showed a decreased Hb level from 10.6mg/dl to 8.4mg/dl in 5 hours after admission. Also, renal angiography revealed a right renal artery hemorrhage, and catheter embolization was performed. Fever and anemia have been recovered after 1 month admission by drain tube insertion on the site of right perirenal hematoma which has been found to be liquefactioned. Case 2: A 56 year-old female who had received 20 years of hemodialysis presented with left abdominal pain. She also had a history of renal failure due to membranous glomerulonephritis . Initial vital sign was 206/87 mmHg, heart rate 55/min, respiratory rate 20/min, body temperature 36.5 Celsius. Her laboratory data showed a decreased Hb level from 10.7mg/dl (2 months ago) to 7.4mg/dl on admission. Abdominal pelvis computed tomography showed left perirenal hemorrhage. Therefore, she received a blood transfusion and stayed in absolute bed rest. At 6th days after admission, her anemic condition was found to have improved after all. Conclusions : These case reports demonstrates spontaneous renal hemorrhage should be considered in the differential diagnosis of unexplained pain before drop in blood pressure or hematocrit occurs.
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