Ruptured renal artery aneurysm during pregnancy, a clinical dilemma

BACKGROUND: Rupture of a renal artery aneurysm (RAA) during pregnancy is a rare event, with a high mortality rate for both mother and fetus. Increased blood flow and intra-abdominal pressure, and vascular changes secondary to increased steroid production are postulated as contributory to the increased risk of rupture during pregnancy. CASE PRESENTATION: We present here a case report of total avulsion of solitary kidney secondary to rupture of RAA in a pregnant patient with congenital absence of the contralateral kidney. The main indication for nephrectomy was severely damaged kidney. Diagnosis was made during operation and both mother and fetus were saved. There are no previous reports of an intact renal artery aneurysm diagnosed either antepartum or postpartum. CONCLUSION: The possibility of a ruptured RAA should be considered in pregnant women with evidence of retroperitoneal hemorrhage. This case was unusual because it occurred in a solitary kidney, during the third trimester of pregnancy

Describing knowledge encounters in healthcare: a mixed studies systematic review and development of a classification

This review was self-funded

Risk of ESKD in related older living kidney donors

ABSTRACTLiving kidney donors who are biologically related to the recipient have higher risk for end-stage kidney disease (ESKD) compared with those who are unrelated to the recipient. This risk is greater for first-degree relatives than more distant relatives. To understand if this holds true for older donors, who were cleared for donation and might be past the peak-age for hereditary disease, we used donor data (SRTR) linked to ESKD registry data (CMS) and stratified donors by age (younger vs older [≥50 years]) and race (black, Hispanic, and white). Younger related donors of all racial groups had higher risk of ESKD compared with younger unrelated donors; however, only older related white and Hispanic donors had higher risk of ESRD compared with unrelated older donors (2.3-fold for white full-siblings and 1.9-fold for white parents/offspring; 3.3-fold for Hispanic full-siblings and 2.0-fold for Hispanic parents/offspring). Older related black donors did not have higher risk compared to older unrelated black donors (0.8-fold for black full-siblings and 0.5-fold for black parents/offspring). Our study points to an earlier age of onset of kidney disease in black donors with a family history of ESKD. Our findings call for programs that promote living donation among related older black donor candidates.</jats:p