Case report: Successful reversal of chronic kidney disease by epidural block with lidocaine

IgA nephropathy (IgA N) is a leading cause of chronic kidney disease (CKD) and renal failure. However, none of the information regarding the pathogenesis of this disease suggests a curable time-limited event. This case demonstrates the feasibility of anesthesia technique for the reversal of IgA N. A 57-year-old male presented with hematuria and proteinuria. Considering the patient’s clinical and kidney biopsy characteristics, the final diagnosis was IgA N. Epidural block was located at T6 and sustained via patient-controlled analgesia pump, delivering 0.8 % lidocaine in rapid bolus injections of 6 mL (with a lockout interval of 180 min) for 16 h daily. Following seven months of treatment, Blood pressure was stable and antihypertension drugs halted during the study period. Kidney function also got improved throughout the study in the patient, whether assessed by eGFR (from 56.18 mL/min (1.73 ㎡) to 72.9 mL/min (1.73 ㎡)) or serum creatinine concentration (decreased from 128.9 μmol/L to 103.2 μmol/L). The patient experienced a > 80 % reduction in proteinuria from baseline, and exhibited a complete remission of hematuria. In this case, epidural block with lidocaine successfully reverses the patient from stage 3 to stage 2 of CKD. These data suggest the feasibility of anesthesia technique for the treatment of IgA N.