Chothia MY, Davids MR, Bhikoo R. Awakening the sleeping kidney in a dialysis-dependent patient with fibromuscular dysplasia: A case report and review of literature. World J Nephrol 2018; 7(7): 143-147 [PMID: 30510913 DOI: 10.5527/wjn.v7.i7.143]
Corresponding Author of This Article
Mogamat-Yazied Chothia, MD, Senior Lecturer, Renal Unit, Tygerberg Hospital, Francie van Zijl Drive, Parow Valley, Cape Town 7505, South Africa. yaziedc@sun.ac.za
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mogamat-Yazied Chothia, Renal Unit, Tygerberg Hospital, Cape Town 7505, South Africa
Mogamat-Yazied Chothia, Mogamat Razeen Davids, Raisa Bhikoo, Division of Nephrology, Department of Medicine, Tygerberg Hospital and Stellenbosch University, Cape Town 7505, South Africa
Author contributions: Chothia MY and Davids MR were involved in the care of the patient; all of the authors contributed to writing of the paper and review of the final manuscript.
Informed consent statement: The patient provided consent for publication of this case report and its accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non- commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mogamat-Yazied Chothia, MD, Senior Lecturer, Renal Unit, Tygerberg Hospital, Francie van Zijl Drive, Parow Valley, Cape Town 7505, South Africa. yaziedc@sun.ac.za
Telephone: +27-21-9386590 Fax: +27-21-9385555
Received: August 15, 2018 Peer-review started: August 17, 2018 First decision: August 31, 2018 Revised: September 6, 2018 Accepted: October 10, 2018 Article in press: October 10, 2018 Published online: November 24, 2018
ARTICLE HIGHLIGHTS
Case characteristics
We report the case of a young woman with renal artery stenosis (RAS) due to fibromuscular dysplasia who became dialysis dependent following arterial dissection; after surgical revascularization, the patient was able to stop dialysis.
Clinical diagnosis
Renal artery stenosis secondary to fibromuscular dysplasia complicated by arterial dissection and subsequent dialysis dependence.
Differential diagnosis
Renal artery stenosis secondary to Takayasu’s arteritis.
Imaging diagnosis
Three-dimensional computed tomography reconstruction indicating a rich collateral renal blood supply and confirming the origins and extent of the renal artery stenosis.
Pathological diagnosis
Kidney biopsy confirming viable tissue.
Treatment
Surgical revascularization by ex vivo repair of the renal artery using a saphenous venous graft.
Related reports
The paper by Libertino et al is important for readers to appreciate how to identify those patients that are likely to have a good response to revascularization.
Term explanation
The “sleeping” kidney refers to a non-functional but potentially viable kidney that may recover function following revascularization.
Experiences and lessons
Patients with RAS should be evaluated for revascularisation before fully committing them to a life of chronic dialysis.
