POSTRENAL ACUTE KIDNEY INJURY SECONDARY TO URINARY RETENTION FROM BENIGN PROSTATIC HYPERPLASIA COMPLICATED BY MULTIDRUG-RESISTANT ACINETOBACTER INFECTION AND CHRONIC PULMONARY THROMBOEMBOLISM: A CASE REPORT

XHAFERI, Almira and MUSTAFAI, Zehra and SAITI, Rihan (2026) POSTRENAL ACUTE KIDNEY INJURY SECONDARY TO URINARY RETENTION FROM BENIGN PROSTATIC HYPERPLASIA COMPLICATED BY MULTIDRUG-RESISTANT ACINETOBACTER INFECTION AND CHRONIC PULMONARY THROMBOEMBOLISM: A CASE REPORT. In: INTERNATIONAL CONFERENCE “FROM RESEARCH TO APPLICATION”, 20 May, 2026.

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Abstract

Introduction: Acute kidney injury (AKI) is a frequent and serious condition in elderly patients, often multifactorial and associated with increased morbidity. Postrenal causes, particularly urinary obstruction due to benign prostatic hyperplasia (BPH), represent a reversible etiology if promptly recognized. The coexistence of infection and thromboembolic disease may further complicate the clinical course. Case Presentation: We report an 87-year-old male with multiple comorbidities, including cardiovascular disease and recently diagnosed chronic pulmonary thromboembolism, who presented with acute urinary retention, abdominal pain, fatigue, hemoptysis, and dyspnea. His condition developed in the postoperative setting following intestinal surgery. Diagnostic Assessment: Laboratory findings revealed AKI (creatinine 240 µmol/L, urea 17.5 mmol/L), marked systemic inflammation (CRP 89.7 mg/L), electrolyte disturbances, normocytic anemia, and significantly elevated D-dimer levels. Urinalysis showed severe infection, and urine culture identified multidrug-resistant (MDR) Acinetobacter spp., sensitive only to fosfomycin. Imaging suggested prostatic enlargement and chronic pulmonary thromboembolism. Differential Diagnosis: Considerations included prerenal AKI due to dehydration, intrinsic renal injury, postrenal obstruction, complicated urinary tract infection, pulmonary embolism, and postoperative abdominal complications. Final Diagnosis: Postrenal AKI secondary to urinary retention from BPH, complicated by MDR Acinetobacter urinary tract infection and coexisting chronic pulmonary thromboembolism. Treatment and Management: Immediate bladder decompression via Foley catheterization led to improved urine output. Management included targeted antibiotic therapy based on susceptibility testing, electrolyte correction, hydration, and initiation of tamsulosin for BPH. Outcome and Follow-up: The patient showed clinical improvement with stabilization of renal function and resolution of infection symptoms. Follow-up included monitoring renal parameters, urological evaluation, and assessment of thromboembolic risk. Discussion and Conclusion: This case highlights the importance of early identification of reversible causes of AKI, particularly postrenal obstruction in elderly patients. It underscores the growing challenge of MDR infections and the diagnostic complexity of elevated D-dimer in inflammatory states. A multidisciplinary, systematic approach is essential for optimal management of patients with overlapping renal, infectious, and thromboembolic conditions.

Item Type:	Conference or Workshop Item (Paper)
Subjects:	Q Science > Q Science (General)
Divisions:	Faculty of Law, Arts and Social Sciences > School of Social Sciences
Depositing User:	Unnamed user with email zshi@unite.edu.mk
Date Deposited:	10 Sep 2026 11:37
Last Modified:	10 Sep 2026 11:37
URI:	http://eprints.unite.edu.mk/id/eprint/2383

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