Dirim Ayhan, Celik Huseyin, Hasirci Eray, Aygun Cem, Turunc Tahsin, Ozkardes Hakan, Haberal Mehmet
Department of Urology, Baskent University School of Medicine, Ankara, Turkey.
Exp Clin Transplant. 2010 Mar;8(1):45-8.
To evaluate the results of end-stage renal failure in transplanted cases due to vesicoureteral reflux after a subureteric injection of calcium hydroxyapatite (Coaptite).
Twenty-three patients (39 renal units) with end-stage renal failure secondary to vesicoureteral reflux were included. Reflux was bilateral in 16 cases and unilateral in 7 of the cases. There were 3 degrees of reflux according to the distribution of renal units. They were low-grade reflux (grades 1 and 2; n=10); medium-grade reflux (grade 3; n=23); and high-grade reflux (grades 4 and 5; n=6).
Reflux resolved completely in 17 patients (28 renal units; 71.8%). There was a regression to grade 1 in 3 patients (5 renal units; 12.8%). Twenty-one patients underwent renal transplant; however, 2 of the patients were excluded from the study as it was not possible to monitor them after transplant. Within an approximately 18.6 month follow-up (range, 3-36 months), 1 of the cases had acute, and 3 of the cases had chronic rejection.
Successful results can be achieved in reflux treatment by an injection of subureteric calcium hydroxyapatite before transplant in patients with end-stage renal failure that developed secondary to vesicoureteral reflux.
评估输尿管下注射羟基磷灰石（Coaptite）治疗输尿管膀胱反流所致终末期肾衰竭移植病例的效果。
纳入23例（39个肾单位）因输尿管膀胱反流继发终末期肾衰竭的患者。反流为双侧的有16例，单侧的有7例。根据肾单位分布情况有3度反流。分别为低度反流（1级和2级；n = 10）；中度反流（3级；n = 23）；高度反流（4级和5级；n = 6）。
17例患者（28个肾单位；71.8%）反流完全消失。3例患者（5个肾单位；12.8%）反流减轻至1级。21例患者接受了肾移植；然而，2例患者被排除在研究之外，因为移植后无法对其进行监测。在大约18.6个月的随访期内（范围3 - 36个月），有1例发生急性排斥反应，3例发生慢性排斥反应。
对于输尿管膀胱反流继发终末期肾衰竭的患者，在移植前输尿管下注射羟基磷灰石可成功治疗反流。
