povidone-iodine and Kidney-Diseases

We describe a clinical course of idiopathic chyluria in a previously\ healthy 8-year-old Thai boy, with a 1-year history of cloudy white urine undergoing\ antibiotic treatment. The patient was investigated for the causes but they\ all proved negative. Cystoscopy and retrograde pyelography demonstrated a\ renolymphatic fistula of the right kidney. The patient was refractory to a mediumchain\ triglyceride-rich diet. Ultimately, sclerotherapy with 1% povidone iodine was\ employed twice, which resulted in a resolution of the disorder. We emphasize that\ chyluria, even though a very rare condition of chylous disorders, but ultimately\ can be initially managed by providing a medium-chain triglyceride-rich diet and\ is curable by sclerotharapy. Importantly, medium-chain triglyceride-rich diet can\ be applied to treat other types of chylous disorders.

Topics: Child; Humans; Kidney Diseases; Male; Povidone-Iodine; Sclerotherapy; Treatment Outcome

CASE DESCRIPTION A 6-year-old spayed female Great Pyrenees (dog 1) and a 2-year-old spayed female German Shepherd Dog (dog 2) were evaluated because of gross hematuria of 5 and 2 months' duration, respectively. CLINICAL FINDINGS In both dogs, coagulation times were within reference limits, results of aerobic bacterial culture of urine samples were negative, echogenic debris could be seen within the urinary bladder ultrasonographically, and hematuric urine could be seen exiting the right ureterovesicular junction, with grossly normal urine exiting the left ureterovesicular junction, during cystoscopy. A diagnosis of idiopathic renal hematuria was made in both dogs. TREATMENT AND OUTCOME Both dogs underwent retrograde ureteropyelography, unilateral povidone iodine sclerotherapy, and ureteral stent placement. The right ureter was occluded with a ureteropelvic junction balloon catheter, and a 5% povidone iodine solution was infused into the renal pelvis 3 times. A double-pigtail ureteral stent was then placed. Both dogs recovered without complications, with cessation of gross hematuria within 12 hours. Cystoscopic removal of the ureteral stent was performed in dog 1 after 4 months; at that time, the urine sediment contained 5 to 10 RBCs/hpf. In dog 2, urine sediment contained 50 to 75 RBCs/hpf 2 weeks after sclerotherapy, with continued resolution of gross hematuria 8 weeks after sclerotherapy. The owners declined removal of the stent in dog 2. CLINICAL RELEVANCE Findings suggested that povidone iodine sclerotherapy may be an effective renal-sparing treatment for idiopathic renal hematuria in dogs. Further evaluation with longer follow-up times is warranted.

Topics: Animals; Dog Diseases; Dogs; Female; Hematuria; Kidney Diseases; Povidone-Iodine; Sclerotherapy

Topics: Adult; Humans; Instillation, Drug; Kidney; Kidney Diseases; Kidney Failure, Chronic; Kidney Transplantation; Living Donors; Male; Middle Aged; Nephrectomy; Povidone-Iodine; Time Factors; Treatment Outcome; Urinary Catheterization

We report our experience with the use of povidone iodine instillation into the renal pelvis for the treatment of chyluria.. From August 2006 to November 2008, 26 patients with chyluria were treated. There were 18 males and 8 females ranging from 24-55 years of age. Cystoscopic localization of chylous efflux was done. Povidone iodine as a sclerosing agent was instilled through a ureteric catheter placed in the renal pelvis. A total of 9 doses were given at 8-hour intervals for 3 days. Unilateral instillation was done in 20 cases, and bilateral instillation was done in 6 patients.. Twenty-one of 26 patients showed complete clearance. In 4 patients, recurrence was noted and a repeat injection was given after 4 weeks, with success, in 2 patients. The other two patients required chylolymphatic disconnection. One patient was lost to follow-up.. Our experience shows that povidone iodine is a safe and effective sclerosing agent in the management of chyluria.

Topics: Adult; Chyle; Female; Humans; Instillation, Drug; Kidney Diseases; Kidney Pelvis; Male; Middle Aged; Povidone-Iodine; Urine; Young Adult

The authors report on 7 cases of benign, symptomatic renal cysts treated by percutaneous sclerosis using Betadine solution. The mean size of the cysts was 8 cm and we obtained progressive collapse of all of them. This technique was a simple and effective methode with good results. Indeed, 85% of the cysts disappeard, and only one patient retained a small asymptomatic residual cavity.

Topics: Adult; Aged; Anti-Infective Agents, Local; Cysts; Female; Follow-Up Studies; Humans; Kidney Diseases; Low Back Pain; Male; Middle Aged; Postoperative Care; Povidone-Iodine; Sclerotherapy; Ultrasonography

Povidone-iodine is frequently used as an antiseptic in patients on chronic dialysis. In order to determine if the use of povidone-iodine affects thyroid function in these patients, we measured serum iodine and thyroid hormone levels in dialysis patients prior to and following discontinuation of topical povidone-iodine antiseptics. Serum inorganic iodine levels were elevated initially in nearly 90% of the patients (19 on hemodialysis, 12 on continuous ambulatory peritoneal dialysis [CAPD]). Following discontinuation of povidone-iodine, iodine levels over a 3-month period decreased modestly in patients on CAPD (n = 5) and were unchanged in patients on hemodialysis (n = 5). Total and free thyroxine levels were frequently low but did not correlate with protein-bound or inorganic iodine levels and did not change after discontinuation of povidone-iodine. Thyrotropin levels correlated significantly (r = .62, P less than .01) with inorganic iodine levels in patients on hemodialysis, but not for patients on CAPD. We conclude that abnormal thyroid function tests are common in dialysis patients but are not related to iodine retention or to the routine use of topical povidone-iodine-containing antiseptics.

Topics: Adult; Aged; Female; Humans; Hypothyroidism; Iodine; Kidney Diseases; Male; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Povidone; Povidone-Iodine; Renal Dialysis; Thyroid Function Tests; Thyroid Hormones; Thyrotropin; Thyroxine