[Recurrence of spontaneous kidney rupture in a dialysis patient]

The case is reported of a 35-year-old man who had been treated with hemodialysis for five years because of renal insufficiency due to chronic glomerulonephritis. Renal cystic disease acquired during maintenance dialysis was complicated by bilateral kidney rupture within an interval of two months. Development of cystic changes of kidneys during long-term hemodialysis was first reported in 1977. The main complications of this cystic transformation are, according to the literature, development of neoplasms and hemorrhage into the cysts. In the present case the clinical symptomatology consisted of episodes of severe pain in the flank, hematuria, hypotension and lowering of hematocrit. An ultrasound study demonstrated enlargement of some cysts compared to another study some months ago, and internal echoes due to hemorrhage could be seen in some of the cysts. Because of the danger of spontaneous kidney rupture with consecutive life-threatening hemorrhage, surgery is indicated in such cases.