Radiological reasoning of pulmonary congestion in nephrology. A case report

Castillo Velarde E.; Zuloeta Mundaca R. · Revista Colombiana de Nefrologia (2025) · DOI: 10.22265/acnef.12.3.902

Resumen

Background: Lung congestion has a known clinical spectrum. However, when there are other comorbid variables, the differential diagnosis spreads, and accordingly, the empirical therapy or management approach will depend on the current diagnosis without regard to lung congestion. Hence, there may be bias, overdiagnosis, and overtreatment. Purpose: Recognize mainly a tomographic pattern of lung congestion, differential diagnosis, clinical correspondence, and interpretation in relation to other imaging tests. Case presentation: 68-year-old male transplant patient with chronic allograft nephropathy who is admitted for diarrheal syndrome and dehydration. During their admission, the patient has an intercurrence of transient obstructive uropathy and cardiorenal syndrome due to kidney injury and lung congestion. Due to aggravation, he is transferred to the ICU (intensive care unit) where he is treated as pneumonia in the immunocompromised patient. Finally, the patient improved ventilation and kidney function and was discharged. Discussion and conclusion: The review of this case guides the recognition of lung congestion by the tomographic pattern. It is important to accurately interpret all diagnostic tools, integrate clinicalimaging correlation, and use a Bayesian analysis to clarify the differential diagnosis with the available findings.

Instituciones: Universidad Ricardo Palma