# A concomitant of subarachnoid hemorrhage and idiopathic renal rupture in a hemodialysis patient with COVID-19

## TL;DR

A hemodialysis patient with COVID-19 experienced rare simultaneous occurrences of subarachnoid hemorrhage and idiopathic renal rupture.

## Contribution

This is the first documented case of subarachnoid hemorrhage and idiopathic renal rupture occurring together in a hemodialysis patient with COVID-19.

## Key findings

- The patient showed significant improvement after conservative treatment and renal artery embolization.
- The case highlights a rare and complex clinical scenario involving multiple severe conditions.
- It suggests the need for increased vigilance in managing hemodialysis patients with additional comorbidities.

## Abstract

Idiopathic renal rupture (IRR) is considered an emergency condition in the field of urology. While some cases may have unknown causes, the majority are attributed to specific underlying conditions such as kidney tumors, inflammation, stones, vascular diseases, and coagulation disorders. It is important to note that IRR is not commonly observed in patients undergoing hemodialysis. Herein, we present a unique case of a middle-aged male patient with chronic nephritis syndrome and COVID-19.

The individual experienced severe headache and abdominal pain during the initial stages of hemodialysis, leading to the timely diagnosis of subarachnoid hemorrhage (SH) and IRR. Following the diagnosis, the patient underwent symptomatic conservative treatment for SH and super-selective renal artery embolization for IRR, resulting in gradual relief of his symptoms within three days. After a week, the patient’s overall condition showed significant improvement. To the best of our knowledge, this is the first documented instance of a hemodialysis patient with COVID-19 experiencing SH concurrent with IRR.