Ferreira Cassini M, Cologna A J, Ferreira Andrade M, Lima G J, Medeiros Albuquerque U, Pereira Martins A C, Tucci Junior S
Division of Urology, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Brazil.
Transplant Proc. 2012 Oct;44(8):2373-5. doi: 10.1016/j.transproceed.2012.07.052.
Renal transplantation remains the optimal treatment of patients with end-stage renal disease. Urinary lithiasis represents an unusual urologic complication in renal transplantation, with an incidence of <1%. Today, recipients of kidneys from deceased donors are more likely to receive grafts with undiagnosed lithiasis, which does not occur in patients from living donors, owing to screening with computerized tomography.
The aim of this study was to evaluate the incidence, diagnosis, and therapeutic management of renal lithiasis in transplanted kidneys at a single institution.
We reviewed the medical records for 1,313 patients who underwent kidney transplantation from February 1968 to February 2011.
Among the grafts, 17 patients (1.29%) had nephrolithiasis: 9 women and 8 men. Ages ranged from 32 to 63 years (mean = 45.6 years). Fifteen patients received kidneys from cadaveric and only 2 from living related donors. Two stones, both located inside the ureter, were identified during transplant surgery (11.7%). Three instances of lithiasis were incidentally diagnosed by ultrasound during graft evaluation, within 7 days after surgery (17.6%); all 3 were in the calyces. The 12 remaining patients had the stones diagnosed later (70.58%): 6 in the calyces, 3 in the renal pelvis, and 3 inside the ureter.
Urinary lithiasis is a rare complication in renal transplantation. In most patients the condition occurs without pain. The diagnosis and treatment options for graft urolithiasis are similar to those patients with nephrolithiasis in the general population. Extracorporeal shock wave lithotripsy (ESWL) was the most common treatment method.
肾移植仍然是终末期肾病患者的最佳治疗方法。尿路结石是肾移植中一种不常见的泌尿系统并发症，发病率<1%。如今， deceased donors肾移植受者更有可能接受患有未被诊断出结石的移植物，而由于计算机断层扫描筛查，living donors肾移植患者不会出现这种情况。
本研究的目的是评估单一机构中移植肾尿路结石的发病率、诊断和治疗管理。
我们回顾了1968年2月至2011年2月期间接受肾移植的1313例患者的病历。
在这些移植物中，17例患者（1.29%）患有肾结石：9名女性和8名男性。年龄范围为32至63岁（平均=45.6岁）。15例患者接受了尸体肾，只有2例接受了living related donors肾。在移植手术期间发现2块结石，均位于输尿管内（11.7%）。3例结石在术后7天内进行移植评估时通过超声偶然诊断出（17.6%）；所有3例均在肾盏。其余12例患者的结石后来被诊断出（70.58%）：6例在肾盏，3例在肾盂，3例在输尿管内。
尿路结石是肾移植中一种罕见的并发症。大多数患者发病时没有疼痛。移植肾尿路结石的诊断和治疗选择与普通人群中肾结石患者的相似。体外冲击波碎石术（ESWL）是最常见的治疗方法。
