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タイトル: ビタミンK欠乏症により血尿を来たし急性腎後性腎不全に至った1例
その他のタイトル: A Case of Acute Postrenal Renal Failure Caused by Hematuria Due to Vitamin K Deficiency
著者: 東郷, 容和  KAKEN_name
岡本, 貴行  KAKEN_name
梶尾, 圭介  KAKEN_name
近藤, 宣幸  KAKEN_name
著者名の別形: TOGO, Yoshikazu
OKAMOTO, Takayuki
KAJIO, Keisuke
KONDOH, Nobuyuki
キーワード: Vitamin K deficiency
Acute postrenal renal failure
N-methyl tetrazole thiol group
発行日: 30-Jun-2021
出版者: 泌尿器科紀要刊行会
誌名: 泌尿器科紀要
巻: 67
号: 6
開始ページ: 225
終了ページ: 228
抄録: A 51-year-old male was hospitalized at another hospital for aspiration pneumonia during gastrostomy management due to sequelae related to a cerebral hemorrhage. The patient was referred to our hospital because of gross hematuria and renal dysfunction following fasting and antibiotic administration. Serum creatinine was 10.54 mg/dl. Prothrombin time (PT) and PT-international standard ratio (PT-INR) were beyond the measurement range, while activated partial thromboplastin time (APTT) was 125 seconds, and protein induced by vitamin K absence or antagonist-II (PIVKA-II) was 117, 591 mAU/ml. Computed tomography (CT) imaging showed blood clots in both upper urinary tracts and urinary tract obstruction was considered to be the cause of renal dysfunction. Based on the findings following fasting and long-term administration of antibiotics, including the N-methyl tetrazole thiol (NMTT) group, we considered that the cause was vitamin K deficiency. The patient was immediately treated with menatetrenone (20 mg). Four days after beginning administration, PT, PT-INR, and APTT were improved, and gross hematuria had disappeared. Thereafter, urine volume was increased and renal function became normalized, while PIVKA-II was decreased to the normal range. When a fasting patient has a bleeding tendency during antibacterial administration, it is necessary to consider treatment with vitamin K deficiency.
著作権等: 許諾条件により本文は2022-07-01に公開
DOI: 10.14989/ActaUrolJap_67_6_225
URI: http://hdl.handle.net/2433/264498
PubMed ID: 34265896
出現コレクション:Vol.67 No.6

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