A man in his 70s with anti-glomerular basement membrane disease required hemodialysis and received corticosteroid therapy. Hemodialysis was discontinued after 8 weeks. About 9 weeks after discontinuation, the patient experienced disturbance of consciousness which improved after a few days. However, he subsequently showed fever, urinary retention, re-elevation of C-reactive protein, and persistent pyuria. Computed tomography indicated rupture of a prostatic abscess into the retroperitoneal space. Escherichia coli was identified in urine and blood culture samples. The prostatic abscess, including pyuria, was treated with transrectal ultrasound-guided transperineal percutaneous drainage and antibiotic therapy. Risk factors for prostatic abscess in our patient included an immunosuppressive state, hemodialysis, and oliguria. Although he began to show pyuria with nephritic urinalysis, almost without nitrite reaction after hemodialysis introduction, he did not exhibit prostatic abscess-associated findings until just before the rupture diagnosis. Prostatic abscesses are uncommon in developed countries, and spontaneously ruptured ones are even rarer. However, they can be fatal. The interpretation of urinalysis during hemodialysis due to rapidly progressive glomerulonephritis is difficult. When pyuria persists, clinicians should consider the possibility of a prostatic abscess using imaging, even if signs of an infectious disease are not apparent.

Uremic pericarditis in patients with impaired kidney function is relatively rare. In this report, we describe two cases of cardiac tamponade in men who underwent dialysis reinitiation after kidney transplantation. Case 1 was a 41-year-old man who underwent peritoneal dialysis at 31 years old due to IgA nephropathy, followed by living donor kidney transplantation 7 months later. Three months after reinitiation, chest pain and hypotension led to a diagnosis of cardiac tamponade, and pericardial drainage was performed. Case 2 was a 48-year-old male who started hemodialysis at 25 years old due to IgA nephropathy and underwent cadaveric kidney transplantation at 34 years old. On the 10th day after dialysis reinitiation, he developed hypotension and dyspnea during dialysis, and pericardial drainage was performed with a diagnosis of cardiac tamponade. Thereafter, dialysis was continued with nafamostat mesilate, and aspirin and colchicine were started. Both patients were discharged from the hospital without recurrence. Drug therapy may be effective in preventing uremic pericarditis recurrence in dialysis patients with severe pericarditis who present with cardiac tamponade.