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Polycythemia and increased erythropoietin in a patient with chronic kidney disease

Nature Clinical Practice Nephrology volume 3, pages 222–226 (2007)Cite this article

Abstract

Background A 16-year-old white male with a history of obstructive uropathy presented to a pediatric outpatient clinic with a first syncope. At presentation, he had a hemoglobin level of 220 g/l, a serum erythropoietin level of 27.4 U/l and a serum creatinine level of 200.7 µmol/l (2.27 mg/dl).

Investigations Physical examination, serum laboratory analysis, renal ultrasound, MRI, and 99mTc-MAG3 scintigraphy of the kidneys.

Diagnosis Chronic renal insufficiency caused by obstructive hydronephrosis and accompanied by increased erythropoietin levels of renal origin and polycythemia.

Management Serial phlebotomies and laparoscopic removal of the right hydronephrotic kidney.

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Figure 1: Magnetic resonance image of the urogenital tract at presentation, demonstrating massive hydronephrosis of both kidneys
Figure 2: Renal clearance with 99mTc-MAG3 scintigraphy demonstrating the absence of function in the right kidney
Figure 3

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Authors and Affiliations

  1. S Stark is a Resident in the Department of Neonatology, B Winkelmann is a Senior Resident in the Department of Urology and Pediatric Urology, C Kluthe is a Resident in the Department of Neonatology, U Querfeld is Full Professor of Pediatrics and Head of the Pediatric Nephrology Department, and D Müller is Assistant Professor in the Department of Pediatric Nephrology, J Roigas is Professor of Urology and Head of the Pediatric Urology and Childhood Renal Transplantation Unit, all at the University Hospital Charité of Berlin, Germany.,

    Simone Stark, Björn Winkelmann, Christof Kluthe, Jan Roigas, Uwe Querfeld & Dominik Müller

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  1. Simone Stark
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  2. Björn Winkelmann
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Correspondence to Dominik Müller.

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The authors declare no competing financial interests.

Supplementary information

Supplementary Information

additional references for cases shown in Table 1. (DOC 46 kb)

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Stark, S., Winkelmann, B., Kluthe, C. et al. Polycythemia and increased erythropoietin in a patient with chronic kidney disease. Nat Rev Nephrol 3, 222–226 (2007). https://doi.org/10.1038/ncpneph0437

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