Hassan I, Juncos L A, Milliner D S, Sarmiento J M, Sarr M G
Department of Surgery, Mayo Clinic, Rochester, Minn 55905, USA.
Mayo Clin Proc. 2001 Jul;76(7):758-60. doi: 10.4065/76.7.758.
Enteric hyperoxaluria is a commonly seen adverse event after the jejunoileal bypass procedure. The increased concentration of urinary oxalate predisposes bypass patients to various renal complications such as nephrolithiasis and oxalate nephropathy. If not diagnosed and appropriately treated, these complications can lead to irreversible renal damage. We describe 3 patients in whom severe renal complications developed with irreversible compromise of renal function after a jejunoileal bypass. Patients who undergo a jejunoileal bypass require lifelong follow-up with close monitoring of their renal function. Marked decline in renal function mandates prompt investigation and aggressive intervention, including reversal of the jejunoileal bypass if necessary. Chronic renal failure secondary to oxalate nephropathy is preventable and treatable but may require conversion of a jejunoileal bypass to a more current form of bypass.
肠源性高草酸尿症是空肠回肠旁路手术后常见的不良事件。尿草酸浓度升高使接受旁路手术的患者易发生各种肾脏并发症,如肾结石和草酸肾病。如果不进行诊断和适当治疗,这些并发症可导致不可逆转的肾损害。我们描述了3例在空肠回肠旁路手术后出现严重肾脏并发症且肾功能出现不可逆转损害的患者。接受空肠回肠旁路手术的患者需要终身随访,密切监测其肾功能。肾功能显著下降需要及时进行检查并积极干预,必要时包括逆转空肠回肠旁路手术。草酸肾病继发的慢性肾衰竭是可预防和可治疗的,但可能需要将空肠回肠旁路手术转换为更新的旁路手术形式。