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Wunderlich syndrome, defined as spontaneous nontraumatic renal hemorrhage, is a rare clinical entity. We present a case of Wunderlich syndrome in a 62-year-old male patient with type 2 diabetes mellitus and benign prostatic hyperplasia (BPH) who presented with recurrent hematuria and was found to have a Grade III left renal hematoma. The patient underwent exploratory laparotomy and left nephrectomy. The postoperative course was marked by hematuria, necessitating close monitoring and management. Nephrology consultation was obtained, with recommendations for avoiding nephrotoxic agents and careful monitoring of renal function. The patient was eventually discharged without complications. This case highlights the importance of considering spontaneous renal hemorrhage in patients with diabetes and BPH, as well as the potential for successful surgical management.
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http://dx.doi.org/10.7759/cureus.88139 | DOI Listing |
Introduction: Continuous renal replacement therapy (CRRT) is often performed for critically ill patients in intensive care units (ICUs), but its optimal indication and settings have yet to be determined. Thus, we aimed to describe the current status of CRRT in Japan through a multicenter retrospective observational study.
Methods: Adult ICU patients receiving CRRT at 18 tertiary hospitals in Japan (up to 100 patients from each hospital over the past year) were retrospectively enrolled.
JCI Insight
September 2025
Division of Nephrology, Boston University Chobanian & Avedisian School of Medicine, Boston, United States of America.
Background: Active vitamin D metabolites, including 25-hydroxyvitamin D (25D) and 1,25-dihydroxyvitamin D (1,25D), have potent immunomodulatory effects that attenuate acute kidney injury (AKI) in animal models.
Methods: We conducted a phase 2, randomized, double-blind, multiple-dose, 3-arm clinical trial comparing oral calcifediol (25D), calcitriol (1,25D), and placebo among 150 critically ill adult patients at high-risk of moderate-to-severe AKI. The primary endpoint was a hierarchical composite of death, kidney replacement therapy (KRT), and kidney injury (baseline-adjusted mean change in serum creatinine), each assessed within 7 days following enrollment using a rank-based procedure.
JAMA Netw Open
September 2025
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock.
Importance: Patients with kidney failure (KF) receiving long-term dialysis have increased incidence of atrial fibrillation (AF). Patients with KF and AF have increased risk of stroke, death, and bleeding compared with age-matched cohorts. In KF, the use of oral anticoagulants (OACs) increases hemorrhage risk, offsetting potential benefits and making left atrial appendage occlusion (LAAO) a potentially promising solution for risk reduction in AF.
View Article and Find Full Text PDFWorld J Urol
September 2025
Department of Urology and Transplantation Surgery, Nantes University Hospital, Nantes, France.
Purpose: In 5-10% of cases, renal cancer extends into the venous system, particularly the inferior vena cava (IVC), which worsens prognosis. This study aims to assess morbidity, mortality, and oncological outcomes of patients treated surgically for renal cancer with IVC extension over a 30-year period, in two experienced centers.
Materials And Methods: This bicentric, retrospective study analyzed patients treated between 1988 and 2020 for renal cancer involving the IVC.
Rheumatol Int
September 2025
Clinical Department of Rheumatology, Immunology and Internal Medicine, University Hospital in Kraków, Jakubowskiego 2, Kraków, 30-688, Poland.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by complex disturbances in both innate and adaptive immune responses, often leading to multi-organ involvement. One of the key features of SLE pathogenesis is endothelial dysfunction, which contributes to immune cell infiltration and vascular inflammation. In this context, adhesion molecules such as platelet endothelial cell adhesion molecule-1 (PECAM-1), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) may reflect the degree of endothelial activation.
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