[Acute renal failure in the course of IgA nephropathy in a 16-year-old boy]

Acute renal failure (ARF) is a rare presentation of IgA nephropathy (IgAN). It can be associated with the episodes of macroscopic haematuria, being then usually reversible, or it develops in the course of progressive glomerulopathy with extracapillary proliferation. In the first case ARF is attributed to tubular obstruction by red blood cell casts. We present the case of a 16-year-old boy with non-oliguric ARF in the course of IgAN. He was admitted to the urology unit with 4-day history of gross haematuria, severe loin pain, fever and vomiting. A year before admission he had a short episode of macrohaematuria without any other accompanying symptoms. His family history was not relevant. As the patient was suspected to have acute renal colic in the course of nephrolithiasis, intravenous urography was performed. Since no urinary tract visualisation was obtained, laboratory investigation was carried out revealing marked renal dysfunction with serum creatinine level of 743.3 mumol/l and serum urea of 49.3 mmol/l. The patient was transferred to our department, where conservative treatment was administered (dialysis was not instituted). A rapid improvement in renal function was observed; it returned to normal within 2 weeks. The biopsy findings were consistent with IgAN.