Goldberg Ryan J, Weng Francis L, Kandula Praveen
Renal & Pancreas Transplant Division, Saint Barnabas Medical Center, Livingston, NJ, USA.
Renal & Pancreas Transplant Division, Saint Barnabas Medical Center, Livingston, NJ, USA.
Med Clin North Am. 2016 May;100(3):487-503. doi: 10.1016/j.mcna.2016.01.002. Epub 2016 Mar 21.
Allograft dysfunction after a kidney transplant is often clinically asymptomatic and is usually detected as an increase in serum creatinine level with corresponding decrease in glomerular filtration rate. The diagnostic evaluation may include blood tests, urinalysis, transplant ultrasonography, radionuclide imaging, and allograft biopsy. Whether it occurs early or later after transplant, allograft dysfunction requires prompt evaluation to determine its cause and subsequent management. Acute rejection, medication toxicity from calcineurin inhibitors, and BK virus nephropathy can occur early or later. Other later causes include transplant glomerulopathy, recurrent glomerulonephritis, and renal artery stenosis.
肾移植后同种异体移植肾功能障碍在临床上通常无症状，通常表现为血清肌酐水平升高，同时肾小球滤过率相应降低。诊断评估可能包括血液检查、尿液分析、移植肾超声检查、放射性核素成像和移植肾活检。无论移植后早期或晚期发生，同种异体移植肾功能障碍都需要及时评估，以确定其原因及后续治疗。急性排斥反应、钙调神经磷酸酶抑制剂的药物毒性和BK病毒肾病可在早期或晚期发生。其他晚期原因包括移植肾肾小球病、复发性肾小球肾炎和肾动脉狭窄。
