Hemolysis and acute kidney failure

Qi Qian, Karl A. Nath, Yiming Wu, Tarek M. Daoud, Sanjeev Sethi

Research output: Contribution to journalArticlepeer-review

85 Scopus citations

Abstract

Deposits of iron and hemosiderosis in the kidney have been observed in diseases with intravascular hemolysis, including paroxysmal nocturnal hemoglobinuria, and valvular heart diseases and prosthetic heart valve implants. However, the decrease in kidney function associated with hemolysis caused by cardiac valvular disease or prostheses is less well recognized. We present a case of intravascular hemolysis after repair and banding of the mitral valve that resulted in massive renal tubular deposition of hemosiderin with decreased kidney function. We discuss the pathophysiologic process of both acute and chronic tubular injury from heme and heme proteins, including injury to organelles resulting in autophagic vacuoles containing damaged organelles, such as mitochondria. We conclude that tubular injury resulting from heme proteins should be considered as a cause of decreased kidney function in all patients with a cardiac valvular disease or prosthesis.

Original languageEnglish (US)
Pages (from-to)780-784
Number of pages5
JournalAmerican Journal of Kidney Diseases
Volume56
Issue number4
DOIs
StatePublished - Oct 2010

Keywords

  • Hemolysis
  • acute tubular necrosis
  • mitral valve annuloplasty
  • renal failure
  • renal hemosiderosis

ASJC Scopus subject areas

  • Nephrology

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