Sun Wen, Guo Hong-Bo, Xie Ze-Lin, Zhang Lei, Tian Ye, Lin Jun
Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2013 Oct 18;45(5):779-81.
To investigate the factors in association with colorectal disorders in adult renal transplant recipients.
A retrospective cohort study was carried out with clinical, microbiological and management data regarding diarrhea in 513 renal transplant recipients from Jan. 2007 to Dec. 2012.
Of the 513 patients, 118(23.00%) with no history of ulcerative colitis, were found to have diarrhea after kidney transplantation. In the 118 patients, diarrhea was probably caused by administration of immunosuppressive agents in 65 cases (55.08%), in 30 cases (25.42%) diarrhea was antibiotics associated, and in 23 cases (19.49%) it was due to infections, including bacterial, fungal and viral infections. Diarrhea occurred soon after transplantation in most cases. Of the 118 patients, the symptom of diarrhea occurred in the first 1 month in 84 cases (71.19%), and in the next 5 months in 16 cases (13.56%), and the other 18 cases (15.05%) occurred after 180 days after transplantation. Of the 118 patients, 84 cases (71.19%) were relieved or cured after proper diets, the symptomatic therapy or the adjust meat of the doses of immunosuppressive agents: 18 cases (15.25%) needed to use or adjust the antibiotics , 16 cases (13.56%) had to stop mycophenolate mofetil and convert to other drugs.
Immunosuppressive agents, antibiotics and infection are the common causes of diarrhea after kidney transplantation. The outcome is good with appropriate conservative management.
探讨成年肾移植受者结直肠疾病的相关因素。
对2007年1月至2012年12月期间513例肾移植受者腹泻的临床、微生物学及管理数据进行回顾性队列研究。
513例患者中，118例（23.00%）无溃疡性结肠炎病史，在肾移植后出现腹泻。在这118例患者中，腹泻可能由免疫抑制剂引起的有65例（55.08%），与抗生素相关的有30例（25.42%），因感染（包括细菌、真菌和病毒感染）导致的有23例（19.49%）。多数病例腹泻在移植后不久发生。118例患者中，腹泻症状在移植后第1个月内出现的有84例（71.19%），接下来5个月内出现的有16例（13.56%），另外18例（15.05%）在移植180天后出现。118例患者中，84例（71.19%）经适当饮食、对症治疗或调整免疫抑制剂剂量后缓解或治愈；18例（15.25%）需要使用或调整抗生素；16例（13.56%）不得不停用霉酚酸酯并换用其他药物。
免疫抑制剂、抗生素及感染是肾移植后腹泻的常见原因。适当的保守治疗效果良好。
