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草酸钙尿石症猫的肾移植:19例(1997 - 2004年)

Renal transplantation in cats with calcium oxalate urolithiasis: 19 cases (1997-2004).

作者信息

Aronson Lillian R, Kyles Andrew E, Preston Alicia, Drobatz Kenneth J, Gregory Clare R

机构信息

Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010, USA.

出版信息

J Am Vet Med Assoc. 2006 Mar 1;228(5):743-9. doi: 10.2460/javma.228.5.743.

Abstract

OBJECTIVE

To determine outcome of renal transplantation in cats with renal failure associated with calcium oxalate urolithiasis.

DESIGN

Retrospective case series.

ANIMALS

19 cats.

PROCEDURE

Medical records were reviewed for evaluation of signalment, preoperative clinical signs, physical examination results, dietary history, clinicopathologic data, abdominal imaging, postoperative diet, complications, and long-term outcome.

RESULTS

The domestic shorthair was the most common breed represented. There were 13 spayed females and 7 castrated males. Mean age was 6.8 years. Clinical signs included weight loss, lethargy, vomiting, anorexia, polyuria, and polydipsia. Before surgery, cats received commercially available canned or dry food (n = 10), a prescription renal failure diet (5), a commercial diet to manage struvite crystalluria (1), or an unknown diet (3). Seventeen cats were anemic. All cats were azotemic. Hypercalcemia was detected in 7 cats. Abdominal imaging revealed nephrolithiasis, ureterolithiasis, or both in all cats. Median duration of survival of all cats was 605 days. Eight cats were alive 282 to 2,005 days (median, 1,305 days) after surgery. Eleven cats died 2 to 1,197 days (median, 300 days) after surgery. Five cats formed calculi in their allograft (120 to 665 days). Two of the 5 cats that formed calculi were hypercalcemic. Four of the 5 cats died following complications associated with formation of calculi.

CONCLUSIONS AND CLINICAL RELEVANCE

Renal transplantation appears to be a viable option for cats in renal failure secondary to calcium oxalate urolithiasis. In addition to reported complications in renal transplant recipients, formation of calculi within the allograft may also occur.

摘要

目的

确定患有与草酸钙尿石症相关的肾衰竭的猫进行肾移植的结果。

设计

回顾性病例系列。

动物

19只猫。

方法

查阅病历以评估动物特征、术前临床症状、体格检查结果、饮食史、临床病理数据、腹部影像学检查、术后饮食、并发症及长期结果。

结果

最常见的品种是家猫。有13只去势雌性猫和7只去势雄性猫。平均年龄为6.8岁。临床症状包括体重减轻、嗜睡、呕吐、厌食、多尿和烦渴。手术前,猫食用市售罐装或干粮(n = 10)、处方肾衰竭饮食(5只)、用于管理鸟粪石结晶尿的商业饮食(1只)或不明饮食(3只)。17只猫贫血。所有猫均有氮质血症。7只猫检测到高钙血症。腹部影像学检查显示所有猫均有肾结石、输尿管结石或两者皆有。所有猫的中位生存时间为605天。8只猫在术后282至2005天(中位时间为1305天)存活。11只猫在术后2至1197天(中位时间为300天)死亡。5只猫在同种异体移植肾中形成结石(120至665天)。形成结石的5只猫中有2只高钙血症。形成结石的5只猫中有4只死于与结石形成相关的并发症。

结论及临床意义

对于继发于草酸钙尿石症的肾衰竭猫,肾移植似乎是一种可行的选择。除了肾移植受者中报告的并发症外,同种异体移植肾内也可能形成结石。

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