内镜下经输尿管内注射聚二甲基硅氧烷预防复发性急性移植物肾盂肾炎。

Endoscopic subureteral polydimethylsiloxane injection and prevention of recurrent acute graft pyelonephritis.

机构信息

Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Nephron Clin Pract. 2011;117(4):c385-9. doi: 10.1159/000321526. Epub 2010 Nov 12.

PMID:21071963

Abstract

BACKGROUND/AIMS: Vesicoureteral reflux (VUR) is an important factor in recurrent acute graft pyelonephritis (AGPN). In this study, we evaluated the effect of subureteral polydimethylsiloxane (PDS) injection on recurrent AGPN in renal transplant recipients with VUR.

METHODS

64 renal transplant recipients with recurrent AGPN were included, 31 (48%) of whom had VUR. Of the patients with VUR, 19 (61%) were treated with PDS and the others were managed with antibiotics. The effect of PDS treatment on recurrent AGPN was evaluated in terms of the overall success rate, the success rate according to VUR grade, and the number of PDS treatments.

RESULTS

The overall success rate of PDS injection was 63%, and the number of AGPN episodes was significantly reduced after injection compared with the number before injection (0.21 vs. 1.34 times/person-year, respectively, p < 0.05). The success rate of PDS treatment differed with the VUR grade (50% in grade 1, 33% in grade 2, 75% in grade 3, and 67% in grade 4). The success rate in the first trial was 67% and in the second it was 50%.

CONCLUSION

PDS injection is an effective treatment for recurrent AGPN in renal allograft recipients with VUR.

摘要

背景/目的：膀胱输尿管反流（VUR）是复发性急性移植物肾盂肾炎（AGPN）的重要因素。在这项研究中，我们评估了在 VUR 的肾移植受者中，经尿道下 PDS 注射对复发性 AGPN 的影响。

方法

纳入 64 例复发性 AGPN 的肾移植受者，其中 31 例（48%）存在 VUR。在 VUR 患者中，19 例（61%）接受了 PDS 治疗，其余患者接受了抗生素治疗。根据 VUR 分级、PDS 治疗次数评估 PDS 治疗对复发性 AGPN 的效果。

结果

PDS 注射的总体成功率为 63%，注射后 AGPN 发作次数明显少于注射前（0.21 次/人-年比 1.34 次/人-年，分别，p<0.05）。PDS 治疗的成功率与 VUR 分级不同（1 级为 50%，2 级为 33%，3 级为 75%，4 级为 67%）。初次试验的成功率为 67%，第二次试验的成功率为 50%。