The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Acute Kidney Cortex Necrosis Caused by Tranexamic-Acid

트라넥사민산에 의해 유발된 급성 신피질 괴사 1예

  • Sung, Ji-Yoon (Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science) ;
  • Jung, Eul-Sik (Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science) ;
  • Choi, Shung-Han (Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science) ;
  • Shin, Dong-Su (Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science) ;
  • Lee, Hyun-Hee (Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science) ;
  • Chung, Woo-Kyung (Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science) ;
  • Chang, Jae-Hyun (Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science)
  • 성지윤 (가천의과학대학교 길병원 내과) ;
  • 정을식 (가천의과학대학교 길병원 내과) ;
  • 최성한 (가천의과학대학교 길병원 내과) ;
  • 신동수 (가천의과학대학교 길병원 내과) ;
  • 이현희 (가천의과학대학교 길병원 내과) ;
  • 정우경 (가천의과학대학교 길병원 내과) ;
  • 장제현 (가천의과학대학교 길병원 내과)
  • Published : 2012.04.01
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Abstract

Kidney cortex necrosis is a relatively rare cause of acute kidney injury and is characterized by complete or partial destruction of the renal cortex, but sparing of the medulla. Tranexamic acid has antifibrinolytic activity and is used to reduce bleeding. We report a rare case of kidney cortex necrosis caused by tranexamic acid. A 49-year-old woman complained of coughing up blood-tinged sputum. She had a history of bronchiectasis and was treated with tranexamic acid for 3 days. Four days after admission, she developed anuria and azotemia. Computerized tomography showed enhancement of the renal medulla, but not the bilateral renal cortex. The patient was treated with hemodialysis, and has since been maintained on hemodialysis for 6 months. Due to the development of kidney cortex necrosis in patients treated with tranexamic acid, all its potential complications should be considered.

급성 신피질 괴사는 급성 신손상의 드문 원인으로 신피질의 부분적 혹은 신피질 전체에 괴사가 나타난다. 트라넥사민산은 항섬유소용해 활성을 가짐으로써 다양한 임상 상황에서 출혈을 감소시키고자 하는 목적으로 사용된다 49세 여자가 혈액 흔적 가래를 주소로 내원하였고, 3일간 트라넥사민산을 투여받았다. 입원 4일 뒤 급성 신손상이 나타났고 혈액투석을 시작하였으며 원인을 찾기 위해 시행한 복부 전산화 단층 촬영에서 급성 신피질 괴사 소견이 보였다. 이후 6개월째 신기능 회복되지 않고 혈액투석 중이다. 트라넥사민산 사용 시에는 급성 신피질 괴사의 합병증도 고려해야 할 것이다.

Keywords

References

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