{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T23:22:26Z","timestamp":1777504946876,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Kidney Health Dis"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:title>Rationale:<\/jats:title>\n                    <jats:p>The AngioJet system is a combined mechanical and pharmacological device used for thrombectomy. As a result of the mechanical disruption of clot, intravascular hemolysis is noted to occur. Rarely, intravascular hemolysis can be severe enough to cause heme pigment\u2013induced acute kidney injury (AKI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presenting concerns of the patient:<\/jats:title>\n                    <jats:p>We describe a case of a 45-year-old man with Child-Pugh class B cirrhosis, Budd-Chiari syndrome, and antiphospholipid antibody syndrome who required thrombectomy following a thrombosed direct intrahepatic portosystemic shunt (DIPS). He developed evidence of worsening anemia, dark urine, direct antiglobulin test\u2013negative intravascular hemolysis, and severe AKI within 24 hours of the procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Diagnosis:<\/jats:title>\n                    <jats:p>Based on his severe AKI in association with elevated hemolytic markers, and the temporal association with the AngioJet procedure, the patient was diagnosed with heme pigment\u2013induced AKI secondary to intravascular hemolysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>The patient remained anuric and became volume-overloaded after fluid resuscitation. He was started on dialysis 72 hours after the procedure. Five days after thrombectomy, hemolytic markers returned to normal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome:<\/jats:title>\n                    <jats:p>The patient received hemodialysis for approximately 3 weeks, followed by renal recovery and cessation of dialysis treatments. Five weeks after the AngioJet procedure, his renal function returned to normal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Teaching points:<\/jats:title>\n                    <jats:p>We present a case of heme pigment\u2013induced AKI following an AngioJet procedure that required initiation of dialysis. Although this rare complication has been reported in the literature, it typically occurs when the procedure is used for larger clot burden (ie, venous thromboembolism). To our knowledge, this is the first case of severe hemolysis with associated AKI following the use of the AngioJet for a thrombosed DIPS. Due to the patient\u2019s comorbid conditions, overlapping clinical features, and lack of appreciation of the hemolysis associated with the AngioJet system, the differential diagnosis of the patient\u2019s AKI was quite broad. Nephrologists should be aware of this complication when managing patients with AKI to direct therapy early and avoid unnecessary diagnostic and therapeutic interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2054358120979233","type":"journal-article","created":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T06:28:57Z","timestamp":1607927337000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["A Case Report of Intravascular Hemolysis and Heme Pigment\u2013Induced Nephropathy Following AngioJet Thrombectomy for Thrombosed DIPS Shunt"],"prefix":"10.1177","volume":"7","author":[{"given":"Si","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Saskatchewan, Saskatoon, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolette","family":"Sinclair","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, University of Saskatchewan, Saskatoon, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2809-1023","authenticated-orcid":false,"given":"Sachin","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Saskatchewan, Saskatoon, Canada"},{"name":"Division of Nephrology, Department of Medicine, University of Saskatchewan, Saskatoon, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,12,14]]},"reference":[{"key":"bibr1-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(07)61823-5"},{"key":"bibr2-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1177\/1526602815592849"},{"key":"bibr3-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1177\/1129729818760977"},{"issue":"1","key":"bibr4-2054358120979233","first-page":"48","volume":"25","author":"Wong P","year":"2019","journal-title":"Hong Kong Med J"},{"key":"bibr5-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefro.2018.06.005"},{"key":"bibr6-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(99)70220-4"},{"key":"bibr7-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1177\/1708538119877322"},{"key":"bibr8-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.12.018"},{"key":"bibr9-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.09.047"},{"key":"bibr10-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1038\/ncpneph1019"},{"key":"bibr11-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(03)00352-4"},{"issue":"3","key":"bibr12-2054358120979233","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1681\/ASN.V103507","volume":"10","author":"Nochy D","year":"1999","journal-title":"J Am Soc Nephrol"},{"key":"bibr13-2054358120979233","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2019.020703"},{"key":"bibr14-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.08.026"},{"key":"bibr15-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1984.00350170131022"},{"key":"bibr16-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510230105"},{"key":"bibr17-2054358120979233","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(94)71475-5"},{"key":"bibr18-2054358120979233","unstructured":"Boston Scientific. ANGIOJET catheter reference guide. https:\/\/www.bostonscientific.com\/content\/dam\/bostonscientific\/pi\/portfolio-group\/Catheter%20Thrombectomy\/AngioJet\/Resources\/AngioJet-Reference-Guide_PI-282523-AA.pdf"},{"key":"bibr19-2054358120979233","doi-asserted-by":"crossref","unstructured":"Esteras R, Cannata-Ortiz P, del Palacio-Tamarit M, et al. Podocyte and tubular involvement in AngioJet-induced kidney injury. Clinical Kidney Journal. 2019. https:\/\/doi.org\/10.1093\/ckj\/sfz104","DOI":"10.1093\/ckj\/sfz104"}],"container-title":["Canadian Journal of Kidney Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2054358120979233","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2054358120979233","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2054358120979233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:23:43Z","timestamp":1777389823000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2054358120979233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":19,"alternative-id":["10.1177\/2054358120979233"],"URL":"https:\/\/doi.org\/10.1177\/2054358120979233","relation":{},"ISSN":["2054-3581","2054-3581"],"issn-type":[{"value":"2054-3581","type":"print"},{"value":"2054-3581","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]},"article-number":"2054358120979233"}}