Abstract
We present a case of idiopathic retroperitoneal fibrosis demonstrating acute renal failure. The patient, a 53-year-old man, complained of lumbago and weight loss. He was referred to our hospital because of acute renal failure, on July 24, 1987. Serum creatinine, blood urea nitrogen, potassium, phosphate and erythrocyte sedimentation rate was elevated, and both CRP and antismooth muscle antibody were positive. Retrograde pyelogram revealed bilateral hydron'ephrosis due to the stenosis of bilateral ureters at the level of the 5th lumbar spine. Then construction of right percutaneous nephrostomy was done on the day of his admission, and that of the left was on August 6, 1987. Soon his renal function improved. Abdominal CT revealed a large retroperitoneal mass with the density of soft tissue. Based upon these findings, we made a diagnosis of idiopathic retroperitoneal fibrosis. After confirming histological diagnosis by biopsy from the mass, we performed bilateral ureterolysis and intraabdominal transposition. Seven days after operation, he began to be treated with steroid administration. Twenty-five days after operation, antegrade pyelogram demonstrated that bilateral hydronephrosis was reduced. We reviewed the association of autoimmune disease with idiopathic retroperitoneal fibrosis and recent therapeutic modalities for this disease.
