Acute Renal Failure Secondary to Coexisiting Postinfectious Glomerulonephritis and Chronic Active Allergic Interstitial Nephritis: A Case Report

NKF 2017 Spring Clinical Meetings Abstracts 1528 Steroid Combined Induced CT and Scleroderma Fluoroscopy Renal Guided Crisis Percutaneous Trans229 peritoneal Jaros, Nephrostomy Tube Insertion and Subsequent Antonin Christos Argyropoulos, Kamran Shaffi, TACROLIMUS INDUCED ATYPICAL HEMOLYTIC UREMIC Nephrolithotomy in a Patient withUniversity Left Ectopic Pelvic Kidney Rawan Al-Odat, Edgar Fischer. of New Mexico, SYNDROME IN RENAL TRANSPLANTATION Ishtiaq Ahmed, NM, Ebadur USA Baylor Rahman, Zahrani. LuAlbuquerque, Pan, Mohanram Narayanan, Scott Tarek and White Medical Prince Sultan Military Medical City, Riyadh, Saudi Arabia 154 Center, AcuteTemple, RenalTX, Failure USA from Supplement Induced Bile Cast 10 Tacrolimus Hemorrhagic Shock andhemolytic Hemoperitoneum as a Fatal ManiSucessfully Treated with Apheresis induced atypical uremic syndrome (aHUS) in festation ofJohnson, Granulomatosis with Polyangiitis renal transplant recipients is characterized by acute allograft Mira Caroline Theresa Kinard, Jillrenal Adamski, dysfunction, microangiopathic hemolytic anemiaSaddekni. (MAHA) and Emad AlMayo Jaber,Clinic Gaurav Jain, Souheil University Keddis. Hospital, Phoenix, AZ, USA thrombocytopenia. The rarity of this condition presents a significant of Alabama Hospital, Birmingham, AL, USA 156 Non-HCV Cryoglobulinemic MPGN with Cold Agglutinin diagnostic challenge. 13 A Rare Case of ANCA Associated – Association or Vasculitis Cause? in a Patient Hemolytic Anemia A 34-year-old female with end stage renal disease due to lupus with Systemic Sclerosis Ghassan Kabbach, Rahim Dhanani, Israel Kasago, George nephritis underwent a deceased donor renal transplantation. After the Sadeem Ali, Austin Rice, Romualdo Mauricio Talento, Nauman Soryal, Bose, Rafia Chaudhry, Monrroy, surgery, the Vivek patient was started on immunosuppressive induction Shahid. East Carolina University and College, Vidant Medical Foulke Hongalgi K. Albany Medical Albany, therapy withL,antithymoglobulin and methylprednisolone. On day 1, the Center, Greenville, NC, USA NY, USA renal allograft started to function and the patient’s creatinine level drop.Hemolytic On day tacrolimus added to the 14 started Atypical Uremic Syndrome Can Present as 159 ZerotoTolerance on 3,Anion Gapwas immunosuppressive regimen. On day 6, her Dysfunction renal allograft function Malignant Hypertension and Renal Sathish Karmegam, Roberto Collazo-Maldonado. Methodist started to deteriorate. Interestingly, her platelet and hemoglobin level Shehzad Ali, Farhang Ebrahimi, Health System, Dallas, TX, USA Mohammad Azmir, El also dropped. Examination of the peripheral blood smear showed Saadi. Richmond University Medical Center, Staten Island, 160 occasional Aldosteronism in Polycystic Kidney Disease: Hypertension schistocytes. Due to the worsening renal allograft function, NY, USA Hidingwas inperformed Plain Sight a biopsy which revealed findings concerning for 20 thrombotic An Unusual Cause of Cast Nephropathy microangiopathy. Since the patient had no signs ofFrederic Chandrashekar Kashyap, James Lynch Bailey, 1 2 1 Faisal University, Anwar , Nada .was University Rawan Al-Odator1,malignant rejection, infection hypertension, theBader patient Rahbari-Oskoui. Emory Atlanta, GA, USA 2 University of of Newwith Mexico, Albuquerque, NM, diagnosed tacrolimus induced aHUS. She USA; was treated with 161 Recognition of Reverse Pseudohyperkalemia Missouri, Kansas City,and MO, USA plasmapheresis, eculizumab discontinuation of tacrolimus. The Siddhartha Joshua L.allograft Rein, function Joseph A. respondedKattamanchi, to theNephrotic treatment and the renal 21 patient Granulomatous Syndrome Secondary to Vassalotti. Icahn School of Medicine at Mount Sinai, New started to improve. Sarcoidosis York, NY, USA a rare complication of tacrolimus therapy in renal This case illustrates Omer Alrawi, Walid Ibrahim, Nehal Altaie, Nashat Imran, 164 transplantation. High Anion Tacrolimus Gap Metabolic Due to 5- Oxoproline inducedAcidosis aHUS is characterized by acute Yahya Osman Malik.Wayne State University, Detroit with Low Dose Acetaminophen allograft dysfunction, MAHA and thrombocytopenia. The underlying Medical Center,due Detroit, MI, USA mechanism to endothelial cell injury and platelet Oladele, Sobia Nis likely Khan, Arun Kottarathara, Opeyemi 23 aggregation. A Rare Case of Spontenous Tumor Lysis Synrome in recognition and appropriate thepray is critical in a Sandeep Prompt Mallipattu, Nand K Wadhwa. Stony Brook Patient with of Poor-Risk Germ Cell Cancer theMedicine, management aHUS in order to prevent renal allograft loss. Stony Brook, NY, USA Mohammed Alzubaidi1, Bhavna Bhasin2. 1Medical Univer165 Thrombotic Thrombocytpopenic Purpura in a Patient with sity of South Carolina, Charleston, SC, USA; 2Medical Goodpasture’s Disease: An Uncommon Association 230College of Wisconsin, Milwaukee, WI, USA Aakanksha Khanna, Nicholas Tan, Matthew R D’Costa, ACETATE-CONTAINING BICARBONATE24 EFFECTS Type BOF Lactic Acidosis Due to Dialysis-Induced Thiamine Sandra MDIALYSATE Herrmann. ON Mayo Clinic, Rochester, MN, USA BUFFERED VENTRICULAR ARRHYTHMIAS a Patient with Seminoma INDeficiency END STAGEinRENAL DISEASE PATIENTS: Mandip Panesar, 167 An Unusual Case of Proteinuria with Rapidly Progressive Ryan Krahn,Amante, Ryan Tulowitzki, , Gregory Gudleski, Winnieof Su,Colorado Mary Brigani Isaac Teitelbaum. University Renal FailureLambert , Brian Murray, Anne B. Curtis, University Muscarella Hospital,, Judy Aurora, CO, USA at Ravkiran Buffalo, Buffalo, NY, USA. Khurana, Tushar Thakur, Andrew Herman, 25 Fresenius Autosomal Dominant Kidney Disease Presenting Medical Care Polycystic Naturalyte dialysate was implicated to Rupesh Raina, Natthavat Tanphaichitr. Cleveland Clinic as a Spontaneous Acute Blood Loss Anemia Hemorincrease serum bicarbonate to dangerous levels throughand its acetate Akron General Akron, OH, USA content associated with sudden cardiac death. We investigated rhagicand Shock 171 theProlonged SGLT-2arrhythmias, Inhibition: effects of Ketoacidosis Naturalyte on Associated the frequencywith of cardiac Ahmad with Anjak, K. Gaitonde, Malhotra, changes C.V. Thakar. correlation electrolyte shifts andA. hemodynamic in 47 A Case Report Cincinnati(HD) VA patients Medical Center, Cincinnati, OH,inUSA hemodialysis using 48-hr Holter monitoring 3 phases: Jatinder Stanley Goldfarb. Hospital ofpost-HD University phase (4Kohli, hr), early post-HD phase (20 hr), and late phaseof 29 HDHypoaldosteronism Presenting with Renal Salt Wasting Philadelphia, PA, pressure USA (BP), mean arterial (24Pennsylvania, hr). Serum HCO 3, Ca, K, blood Disease and Absence of Hyperkalemic Hypercholremic (MAP), and Case heart rate points: 173 pressure An “Atypical” of (HR) Exit were Site measured Infectionat 4intime Peritoneal Acidosis pre-HD, post-HD, 20-hr post-HD, and 44-hr post-HD. No changes were Dialysis made to dialysate or medication We performed Huda Arif, prescriptions David Leehey. Loyolaregimens. University Medical AbhilashChicago, Koratala, Volodymyr Amirto Kazory. Ca and K levels predict time-series analyses ofIL, changes Centre, USAin HCO3, Chornyy, fluctuations in hemodynamics or frequency of cardiac University of Florida, Gainesville, FL, USAarrhythmias. 32 Dialysate Hypokalemic Metabolic Alkalosis and Hypertension HCO3 dose was significantly correlated with change inin 175 serum Severe Acute Kidney Injury from TURP-Associated Heme Blacks HCO3 levels post-HD (r = .48, p < .01), 20 hr post-HD (r = .40), Pigment Nephropathy 1 1 1 and 44 hr post-HD (r = .35, p = .01), but notSingh with changes in BP, , Huzaif Qaisar , Vikas , Mayur K. MAP, Patel1, Arif Asif HR, K, or Ca. Kumar, Results of Behdad the time-series analyses showed that 1Kobrin, neither 1 1 Anubhav Besharatian, Sidney , Suhsil Mehandru , Awais Masud , Loay Indu Sharma levels significantly predicted fluctuations in changes in2 HCO 1 3 or KJonathan Matthew Hogan. University of PennsylSalman . Palmer, Jersey Shore University Medical Center, Seton hemodynamics or cardiac arrhythmias at any time point. However, vania, Philadelphia, PA, USA Hall-Hackensack-Meridian School of Medicine, Neptune, decreased post-HD Ca levels were significantly associated (all p values 2 178 <0.01) A Rare Case of Macrophage Activating Syndrome with Albany Medical College, Albany, NY, USA NJ, USA; with the frequency of premature ventricular contractions (PVCs) Renal Failure during HD phase (r = -.60),Neuropathy: early post-HDAphase (r = -.42),Follow and lateof 33 Ischemic Monomelic Long-Term post-HD phase (r = -.40). Franklin Lam, Katherine 2 Patients Without Fistula Wang, LigationRafia Chaudhry, Krishna were2 Our results1 Swati demonstrate thatAlbany in serum HCO 1changes Medical 1 3 levels Hongalgi, Mehta. College, , Vikas Singh , Huzaif Quaisar , changes. NinaAlbany, Jube Arif Asif notNY, associated with cardiac arrhythmias or hemodynamic The , 1 1 1 USA Mayur K. Patel , InduinSharma Mehandru , Awais relation between a decrease post-HD ,CaSuhsil levels and the frequency of 1 Case of Fibrillary 2 1 180 PVCs A Rare Presenting , Loay . Jersey Shore University Medical Masud might provideSalman a clue for theGlomerulonephritis physiologic mechanism causing with Hemoptysis increased cardiovascular mortality in end-stage renal diseaseofpatients Center, Seton Hall-Hackensack-Meridian School Medi2 undergoing HD with anWebster, acetate-containing bicarbonate-buffered cine, Neptune, NJ, USA; Albany Medical College, Swathi Lavudi, Chris Saleha Rizwan, JamesAlbany, Reilly, dialysate. NY, Tina USA Ko. Allegheny Health Network, Pittsburgh, PA, USA

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37 Amyloidosis Treatment of Presenting Intracardiacwith Mycetoma a Post Renal 181 Nephroticin Syndrome and Transplant Patient of Systemic Nocardiosis with the ComVentricular Hypertrophy ACUTE RENAL FAILURE SECONDARY TO COEXISITING bination Imipenem and Trimethoprim-Sulfamethoxazol Terry Le,ofVittal Chundru, Phani Morisetti. Louisiana State POSTINFECTIOUS GLOMERULONEPHRITIS AND CHRONIC University Health Sciences Center, Shreveport, LA, USA ACTIVE ALLERGIC INTERSTITIAL NEPHRITIS: AMahboob; CASE Ashraf Attia, Ebadur Rahman, Muddassar Prince REPORT. Anastasios Papanagnou, Sanjeev Gupta, Praveen Chander, and Sultan Militaryin Medical City, Riyadh, Saudi Arabia 182 Preeclampsia Association with Mirror Syndrome Yorg Al Azzi, Westchester Medical Center, Valhalla, NY, USA Nonimmune Hydrops Fetalis 40Acute Desalination and Polyuria Associated withinjury Hypertonic interstitial nephritis (AIN) presents as acute kidney Saline andLeddy, Vasopressin in Govindasamy, 3 Hypervolemic Children (AKI) progressing to acuteRajesh renal failure (ARF) after theJamie use of aA.known Julia L. Green. offending and can Center, be associated with pyuria, hematuria andPhysiGeisinger Danville, PA, College USA John agent(s) ScottMedical Baird. Columbia University of white cell casts. Similarly, post-infectious glomerulonephritis (PIGN) cians & New York, NY,hypertension, USA 190 Pancreatic Adenocarcinoma Mimicking Granulomatous can present as Surgeons, hematuria, proteinuria, edema, and AKI. with BothPolyangitis fairly commonFailure with similar clinical presentations, 43 Aconditions Unique are Case of Renal in a Patient with Hepatitis C however, there areLohani, very fewIuliana cases, reporting co-existenece of theseWilliam 2 Sadichhya Niculescu, Zarouk. Krishna Baradhi, Christopher Girgis.Sami University of Oklacommon conditions in the same patient. Beaumont Hospital, Royal Oak, MI, USA Wehoma, presentTulsa, the caseOK, of a USA 76 y/o man with a PMH of HTN, DM-2, CKDIrrelevant stage 3, with a baseline creatinine (SCr) ofCrescentic 1.4 mg/dl, and 193 ANCA Negative Pauci Immune GNinina 44 ‘Calcinosis Cutis’: A serum Marker of Systemic Calcification diabetic neuropathy transferred to our center for further management of aDialysis Man with Rheumatoid Arthritis Patient ARF. He was initially admitted to for an infected left 3rd digit s/p Dipesh Maan, Mark Bunker, Mary Chester Wasko,of Krishna Baradhi, Christopher Girgis. University Oklaamputation treated with unasyn/clindamycin. He then developed a Barbara Clark. Allegheny General Hospital, diffuse, erythematous, pruritic rash with bullae; Pittsburgh, his antibioticsPA, wereUSA homa, Tulsa, OK, USA switched to vancomycin and aztreonam was sent with home. He was 199 Refractory Hyponatremia inand Fungating 45 Spontaneous Renal Infarction ina ahePatient Middle Aged Female on readmitted a week later for symptomatic hypoglycemia and was found Metastatic Melanoma Oral Contraceptives (OCs) to have severe AKI (SCr of 8 mg/dl) with oliguria and refractory acidosis. He received pulse steroids and was transferred to Nwaohiri. our Rui Mao, Thao P dose Tran, Krishna Baradhi. University of Khalid Bashir, Chamberlain Obialo, Nnamdi center; differentialSchool includedof antibiotic induced: acute tubular necrosis Oklahoma, School ofMedicine, Community Medicine, Tulsa, OK, Morehouse Atlanta, GA, USA (ATN), AIN or ATN secondary to hypoglycemia. Therefore, a renal USA 46 Colorful Drug Pigmentation in biopsy was doneSurprises: showing active AINRelated and PIGNUrine with IgA dominance 201 Low on on ‘Lytes: A glomerulosclerosis. superimposed diabetic HeProteinuria required 3 sessions of Outpatient Clinic, aRare CaseEtiology Series for renalKirea replacement therapy (RRT) receiving a steroid taper. His Mazzolini, ElieAlwhile Saber, Samaya Qureshi, Sheryl Jaime Baynes-Fields, Jonathan Lee, Poorvanshi Alag, SCr improved and stabilized to 3.8 mg/dl; he did not need further RRT. Caberto, Rajeev Raghavan. Baylor College of Medicine, Irfan cultures Ahmed,remained Sandeep Aggarwal. Drexel University College His blood negative throughout his stay. Houston, TX,Philadelphia, USA of Medicine, USA case reports of A review of literature revealed onlyPA, 2 previous coexistent PIGN andInterstitial AIN associated with infection and 204 Paradoxical Nephritis ininfluenza a Patient withDisease Crohn 48 Atypical HUS in a (one Patient with Inflammatory Bowel the other with streptococcal infection); both were treated with pulse Disease Zarrabi,taper. Yezina Nigatu, and LeaoneBaer, doseKelly steroidsBeers, followedKevin by a prednisone Both recovered Chaitanya Mishra, Maria Dominick Santoriello, required RRT. This case highlights rare association between PIGN Wilfred Lieberthal. StonyJ.theThomas, Brook Medical Center, Stony and AIN inZanger, the same patient and theS.need for renal biopsy in patients Ron Lawrence Weisberg. Cooper University Brook, NY, USA with overlappingCamden, clinical presentations. USA Complex Glomerulonephritis 49 Hospital, P-ANCA Positive NJ, Immune 209 Role of Dialysis in Acute Toxic Associated with Levamisole UseEncephalopathy Secondary to Hyperammonemia 232 Kelly Beers, Arun Kottarathara, Wilfred Lieberthal, Rajeev Gayatri Rebecca Blonsky, Sevag Demirjian. The Rohatgi. Nair, Northport Medical Center, ASSOCIATION BETWEEN VA HOGA1 VARIANTS ANDNorthport, RISK OF NY, Cleveland Clinic Foundation, Cleveland, OH,Nancy USA USASTONES: KIDNEY Alexander Parker, Michael Heckman, 212 Massive Pneumoperitoneum aRare Patient On CCPD,ofTreated Diehl, Anna Harrell, Arta Palaj, William Mayo Clinic, 52 Granulomatous Prostatitis asinaHaley. Presentation Granwith CTFL, Guided Needle Aspiration Jacksonville, USA ulomatosis with Polyangiitis Mutations in Neustein, the HOGA1 are hypothesized to cause a gainNwakoby. 1 1 Charles Patricia Kachur, Izuchukwu , Rafiagene Chaudhry , Richard Blinkhornof1, Loay Anum Bilal mitochondrial aldolase activity, resulting in 1 4-hydroxy-2-oxoglutarate 1,2 1 Ocala Health, Ocala, FL, USA Salman , Elvira Gosmanova . Albany Medical College, excess oxalate which is a major 2 risk factor for stone formation. The aim 213 Relapse of IgA Nephropathy Following an Episode of Albany, NY, USA; Albany Stratton VA Medical Center, of this case-control study was to sequence HOGA1 and evaluate Rhabdomyolysis Albany,between NY, USA associations HOGA1 variants and risk of calcium oxalate Thu-Cuc Izuchukwu Nwakoby. University of 53 Skin Rash: A of Rare Presentation of Post-Transplant kidney stones. A Nguyen, total 71idiopathic calcium oxalate kidney stone LymCentral Health,All Ocala, FL,were USA patients and 74Florida/Ocala controls were included. subjects unrelated phoproloferative Disorder Caucasians. applying standard quality control procedures, 214 Fibrillary Glomerulopathy and Renal Cell Cancer inSungeun a Situs Anum After Bilal, Llewellyn Foulke, Suzanne Homan, sequencing of HOGA1 revealed a total of 178 variants, almost all ofAlbany Inversus Totalis Patient Kim, David Conti, Loay Salman, Rafia Chaudhry. which were intronic. Associations of common variants (minor allele Medical Nikolaenko, Center, Albany, NY, USA Dmitri Mony Fraer. University of Iowa frequency >2%) with risk of kidney stones were evaluated using Hospital and Clinics, Iowa City, USA 54 It Runs in The Family: A Case of Periodic multivariable logistic regression models. ForIA, rareHyperkalemic variants, these were Paralysis An Unfriendly 215 Staphylococcus summarized descriptively, Pseudintermedius and we also performed a–gene-burden test Companion comparing patients and controls by collapsing across P-values Rebecca Blonsky, Georges Nakhoul. Thevariants. Cleveland Clinic ≤0.05 were considered as statistically ForDilek common variants, Foundation, Cleveland OH, significant. USA Dmitri Nikolaenko, Shaun Fernandes, Ince, M. Lee significant associations withand risk of kidney stones were identified Sanders. University of Iowa, Iowa IA, USA for First – City, Related Peritonitis: 55 Peritoneal Dialysis Pet BITE rs61863283 (Intron 1, OR: 0.44, P=0.025) and rs4919120 (Intron 2, Reported Change Case ofDisease Rhizobium 218 Minimal in a Radiobacter Patient with Infection Systemic from Lupusa OR: 2.08, P=0.043). Although not quite significant, suggestive Cat Bite Erythematosus: A Casefor Report associations were also observed rs7093840 (Intron 1, OR: 0.52, Benjamin Bluen, Lukasz Kiljanek, Hans and Schlecht, Michelle Odianosen Obadan, Rula Abdulrahman, Jose Pace, Rajbir P=0.065), rs77550196 (Intron 2, OR: 3.02, P=0.078), rs11189294 Fuentes, KyleP=0.068). Krevolin, Larry Krevolin. Drexel University Chopra. Saint John’s For Episcopal Hospital, Far Rockaway, (Intron 2, OR: 2.59, rare variants, 5 variants College of Medicine, Philadelphia, PA, USA (rs556115153, rs52946497, rs574981203, rs535992870, rs577468250) NY, USA located in Intron 2 that Control were in complete linkage disequilibrium were 56 Anti-Thymocyte Globulin Induced Acute in a 220 Blood Pressure After Removal of Kidney RenininInjury Secreting observed in 3 with patients and zeroAnemia controls and therefore warrant further Patient Aplastic Atrophied Kidney study. The results of this initial discovery stage provide evidence that Chandrashekar Bohra, Sean Verma, Claude Bassil. Eshetu Obole, Shah, Jason OhioUniverState several HOGA1 variants Robin may be associated with riskProsek. of developing sityoxalate of South Florida, Tampa, FL, USA University Wexner Medical Center, Columbus, USA calcium kidney stones and should be validated in futureOH, studies. 57 A Immune Complex Glomerulonephritis with Persistently – A Case 221 Severe but Nonfatal Case of Hypermagnesemia Negative ANA Assay Report

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Am J Kidney Dis. 2017;69(4):A1-A105