Solà R, del Río G, Villavicencio H
Fundación Puigvert, Barcelona, Spain.
Urol Int. 1990;45(3):188-9. doi: 10.1159/000281706.
Calculus formation in the renal transplanted patient is uncommon and usually represents a late complication of secondary hyperparathyroidism. A case report of a gouty patient with a transplanted cadaveric kidney is presented. The patient presented without hypercalcemia, or urinary infection, or renal tubular acidosis, or ureteral obstruction, or ingestion of antacids, or metabolic disease, or previous graft lithiasis. Five months after transplantation, a large stone within the renal pelvis was observed on an x-ray film. The radiotransparent nucleus, the patient's past history and the acute gouty arthritis he presented in the immediate postoperative period suggested that the nucleus of the calculus might be mainly composed of uric acid. These facts have drawn our attention to the control of the purine metabolism in the renal transplanted patients who have a past history consistent with gout.
肾移植患者中结石形成并不常见，通常是继发性甲状旁腺功能亢进的晚期并发症。本文报告一例接受尸体肾移植的痛风患者。该患者就诊时无高钙血症、尿路感染、肾小管酸中毒、输尿管梗阻、未服用抗酸剂、无代谢性疾病及既往移植肾结石病史。移植后五个月，X线片显示肾盂内有一巨大结石。结石的透光核心、患者既往病史以及术后即刻出现的急性痛风性关节炎提示，结石核心可能主要由尿酸组成。这些事实促使我们关注有痛风病史的肾移植患者嘌呤代谢的控制。
