Proteinuria occurs in 40% of cases, usually mixed tubular and
glomerular (up to 3g/24h).
Haematuria secondary to cystitis, renal calculi, malignant
hypertension, malignancy.
Urinary tract infection may occur in up to 50% of cases, due to
epithelial shedding, stones, stasis and instrumentation. Sterile pyuria is
very common due to renal calculi or renal tubular epithelial celluria.
Ureteric obstruction by necrotic papillary tissue, stone, tumour or
stricture-if associated with infections-may result in a life threatening acute
renal failure.
Management:
- Total avoidance of all NSAIDs is the most important therapeutic
approach. - Maintenance of a high fluid intake (greater than two liters/d).
- Treatment of complications e.g. hypertension, acidosis, infection.
- Careful long-term follow-up for early discovery of complications
e.g. malignancy, infection, stones and renal artery stenosis.