期刊
AMERICAN JOURNAL OF KIDNEY DISEASES
卷 56, 期 4, 页码 780-784出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.ajkd.2010.03.025
关键词
Hemolysis; renal hemosiderosis; acute tubular necrosis; mitral valve annuloplasty; renal failure
资金
- NHLBI NIH HHS [P01 HL055552, P01 HL055552-15] Funding Source: Medline
Deposits of iron and hemosiderosis in the kidney have been observed in diseases with intravascular hemolysis, including paroxysmal nocturnal hemoglobinuria, and valvular heart diseases and prosthetic heart valve implants. However, the decrease in kidney function associated with hemolysis caused by cardiac valvular disease or prostheses is less well recognized. We present a case of intravascular hemolysis after repair and banding of the mitral valve that resulted in massive renal tubular deposition of hemosiderin with decreased kidney function. We discuss the pathophysiologic process of both acute and chronic tubular injury from heme and heme proteins, including injury to organelles resulting in autophagic vacuoles containing damaged organelles, such as mitochondria. We conclude that tubular injury resulting from heme proteins should be considered as a cause of decreased kidney function in all patients with a cardiac valvular disease or prosthesis. Am J Kidney Dis 56: 780-784. (C) 2010 by the National Kidney Foundation, Inc.
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