{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T14:13:25Z","timestamp":1779804805804,"version":"3.53.1"},"reference-count":20,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,5,10]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>Urinary ascites due to spontaneous rupture of the urinary bladder is a rare and frequently misdiagnosed condition that can mimic acute kidney failure through reabsorption of creatinine across the peritoneum. We report the case of a middle-aged woman presenting with abdominal pain, ascites and acute renal failure without an obvious cause. A significant discrepancy between creatinine-based and cystatin-C-based estimated glomerular filtration rate together with elevated creatinine in ascitic fluid confirmed pseudo-renal failure due to urinary ascites. CT scan with a late urography phase identified two small intraperitoneal bladder defects. The patient was successfully treated conservatively with continuous Foley catheter drainage for 6\u2009weeks, resulting in complete recovery. This case highlights the diagnostic value of measuring creatinine in ascitic fluid, the role of cystatin C in suspected pseudo-renal failure and supports conservative management in selected cases of intraperitoneal bladder rupture.<\/jats:p>","DOI":"10.1136\/bcr-2026-273289","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T13:50:13Z","timestamp":1779803413000},"page":"e273289","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Urinary ascites: an often overlooked diagnosis \u2013 key clinical clues for rapid recognition"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4451-1518","authenticated-orcid":false,"given":"Dominik","family":"Arnold","sequence":"first","affiliation":[{"name":"Nephrology, Luzerner Kantonsspital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederieke","family":"Elsinger","sequence":"additional","affiliation":[{"name":"Radiology, Luzerner Kantonsspital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seraina","family":"von Moos","sequence":"additional","affiliation":[{"name":"Nephrology, Luzerner Kantonsspital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"2026052606500420000_19.5.e273289.1","doi-asserted-by":"crossref","first-page":"47","DOI":"10.5173\/ceju.2011.01.art11","article-title":"Conservative treatment of an intraperitoneal bladder perforation","volume":"64","author":"Craggs","year":"2011","journal-title":"Cent European J Urol"},{"key":"2026052606500420000_19.5.e273289.2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1254297"},{"key":"2026052606500420000_19.5.e273289.3","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1111\/bju.15974","article-title":"Spontaneous (idiopathic) rupture of the urinary bladder: a systematic review of case series and reports","volume":"131","author":"Reddy","year":"2023","journal-title":"BJU Int"},{"key":"2026052606500420000_19.5.e273289.4","article-title":"Uroperitoneum as an Atypical Source of Ascites: A Case Report","volume":"16","author":"Bakdash","year":"2024","journal-title":"Cureus"},{"key":"2026052606500420000_19.5.e273289.5","article-title":"Urinary Ascites Mimicking Portal Hypertension in a Healthy Woman With Bladder Microperforation","volume":"18","author":"Hailat","year":"2026","journal-title":"Cureus"},{"key":"2026052606500420000_19.5.e273289.6","doi-asserted-by":"crossref","DOI":"10.3390\/healthcare13131594","article-title":"Feasibility of Conservative Management for Intraperitoneal Bladder Perforation: A Single-Institution Case Series","volume":"13","author":"Singh","year":"2025","journal-title":"Healthcare (Basel)"},{"key":"2026052606500420000_19.5.e273289.7","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group","volume":"105","author":"Stevens","year":"2024","journal-title":"Kidney Int"},{"key":"2026052606500420000_19.5.e273289.8","unstructured":"Gounden V , Bhatt H , Jialal I . Renal function tests. Treasure Island: StatPearls Publishing, 2024."},{"key":"2026052606500420000_19.5.e273289.9","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.1999.00515.x"},{"key":"2026052606500420000_19.5.e273289.10","doi-asserted-by":"publisher","DOI":"10.1159\/000328911"},{"key":"2026052606500420000_19.5.e273289.11","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.2000.80.3.1107"},{"key":"2026052606500420000_19.5.e273289.12","doi-asserted-by":"publisher","DOI":"10.1258\/acb.2012.011241"},{"key":"2026052606500420000_19.5.e273289.13","doi-asserted-by":"crossref","unstructured":"Errabelli P , Lathiya M , Singh D . Case report: A case of pseudo-acute kidney injury due to cyclin-dependent kinase inhibitor. Front Nephrol 2024;4. doi:10.3389\/fneph.2024.1389562","DOI":"10.3389\/fneph.2024.1389562"},{"key":"2026052606500420000_19.5.e273289.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-8981(02)00177-8"},{"key":"2026052606500420000_19.5.e273289.15","doi-asserted-by":"crossref","unstructured":"Murata R , Kamiizumi Y , Tani Y , et al . Spontaneous rupture of the urinary bladder due to bacterial cystitis. J Surg Case Rep 2018;2018. doi:10.1093\/jscr\/rjy253","DOI":"10.1093\/jscr\/rjy253"},{"key":"2026052606500420000_19.5.e273289.16","doi-asserted-by":"crossref","DOI":"10.1186\/s12882-023-03289-w","article-title":"A marked elevation in serum creatinine\/cystatin C ratio may indicate pseudo-acute kidney injury due to urinary ascites: a case report and literature review","volume":"24","author":"Jiang","year":"2023","journal-title":"BMC Nephrol"},{"key":"2026052606500420000_19.5.e273289.17","doi-asserted-by":"crossref","unstructured":"Martens P . Pseudorenal failure secondary to reversed intraperitoneal autodialysis. Case Rep Nephrol 2013;2013. doi:10.1155\/2013\/982391","DOI":"10.1155\/2013\/982391"},{"key":"2026052606500420000_19.5.e273289.18","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1056\/NEJMra2100152","article-title":"Peritoneal Dialysis","volume":"385","author":"Teitelbaum","year":"2021","journal-title":"N Engl J Med"},{"key":"2026052606500420000_19.5.e273289.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2007.04.013"},{"key":"2026052606500420000_19.5.e273289.20","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1995.495"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-273289","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T13:50:15Z","timestamp":1779803415000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-273289"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":20,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,26]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1136\/bcr-2026-273289"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-273289","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}