Case Example

Woman in her 70s

Chief complaint

Previous medical history

Internal dosage

Smoking history

ABI

The patient was admitted to the previous hospital 4 weeks prior to transfer to our hospital due to CS1 heart failure complicated by CKD, and was administered diuretics. Diuretics were discontinued from day 4 due to decreased urine output and suspected dehydration based on FEUN and physical examination findings. However, her weight continued to increase, and although diuretics were resumed, pulmonary edema appeared and emergency ECUM was introduced, followed by uremic symptoms and conversion to dialysis 5 days later.

A simple CT showed a highly calcified stenosis of the abdominal aorta at the level of the left renal artery, and renal artery echo showed undetectable blood flow in the left renal artery. Initially, urine output was maintained. Based on the patient's Cr levels, it was thought that CKD combined with volume reduction and coral reef aorta caused acute kidney injury (AKI), which considered to be the main cause of exacerbation of heart failure. The patient was transferred to our hospital 9 days after the introduction of ECUM with the expectation that revascularization would improve renal function, hypertension, and heart failure.