Abstract
Perirenal hematoma is an uncommon disease caused by trauma, neoplastic disease, renal cyst infection, or other factors. It is sometimes caused by anticoagulant or antiplatelet agents and occasionally occurs in patients on dialysis therapy. When considering the etiology of perirenal hematoma in dialysis patients, acquired cystic disease of the kidney (ACDK) may be an important factor, as all eight patients whom we treated had ACDK. Five of these eight patients had no past history of calculi, neoplastic lesions, or trauma, and perirenal hematoma in these five was associated with rupture of ACDK. Six of the patients with hematoma were peritoneal dialysis patients, and their drained dialysis solutions were all hemorrhagic, suggesting that perirenal hematoma should be considered in the differential diagnosis when bloody drainage is seen in peritoneal dialysis patients. The incidence of ACDK-associated perirenal hematoma is likely to increase with the growing number of long-term dialysis patients. If dialysis patients suddenly complain of lower back pain or if bloody drainage is seen in peritoneal dialysis patients, perirenal hematoma should be considered, and the patient should be subjected to close monitoring. Therapeutic regimens should be established with appropriate consideration of the progression of anemia, the patient's systemic condition, and potential complications of renal cell carcinoma.
