Abstract: PUB006
Transient Anuric AKI Secondary to Parkinson Disease
Session Information
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Author
- Karam, Sabine, Saint George Hospital University Medical Center, Beirut, Lebanon
Introduction
Parkinson's disease is a progressive neurodegenerative disease with diverse motor and neuropsychiatric manifestations. At the urological system level, it can cause neurologic dysfunction of the bladder but to our knowledge, no dysfunction of the upper collecting system has been described so far.
Case Description
A 67-year-old Lebanese female with a PMH of Parkinson’s disease, HTN, DL, DM II, HF, CKD (1.7), Hypothyroidism, recurrent pyelonephritis and nephrolithiasis was admitted on multiple occasions with a chief complaint of “decreased urination”. Physical examination showed no general abnormalities & the patient was afebrile. Upon each admission, a Foley catheter was inserted but with no urine output as she had an empty bladder. Adequate IV fluid hydration did not improve her urine output. The anuria would resolve after a few days with no clear explanation. Renal Scintigraphy using MAG3 technique along with furosemide was performed twice, seven days apart, the first away from an anuric episode and the second during. The first study showed slow cortical emptying into the collecting system but with complete emptying after furosemide while the second study showed accumulation of the tracer in the cortex with minimal spontaneous excretion into the collecting system even after addition of furosemide. There was no evidence of mechanical obstruction or vascular etiology in both studies. An abdominal CT showed no hydronephrosis or evidence of obstructive uropathy. An abdominal MRI showed third spacing and small atrophic kidneys with cortical scarring but no hydronephrosis, calculi, masses, or retroperitoneal fibrosis. The patient had her Parkinson's treatment optimized and the frequency and severity of the episodes decreased.
Discussion
Our findings allow us to speculate that Parkinson's disease could cause neurogenic dysfunction of the upper collecting system that manifests by episodes of intermittent anuria leading to acute kidney injury.