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[肾移植受者的尿石症]

[Urinary lithiasis in renal transplant recipient].

作者信息

Branchereau J, Thuret R, Kleinclauss F, Timsit M-O

机构信息

Service d'urologie et transplantation rénale, CHU de Nantes, 44000 Nantes, France.

Service d'urologie et transplantation rénale, CHU de Montpellier, 34090 Montpellier, France; Université de Montpellier, université de Franche-Comté, 34090 Montpellier, France.

出版信息

Prog Urol. 2016 Nov;26(15):1083-1087. doi: 10.1016/j.purol.2016.08.012. Epub 2016 Sep 16.

Abstract

OBJECTIVES

To report epidemiology and characteristics of urinary lithiasis and its management in kidney allograft at the time of organ procurement or after kidney transplantation.

MATERIAL AND METHODS

An exhaustive systematic review of the scientific literature was performed in the Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of the following keywords (MESH): urinary lithiasis, stone, kidney transplantation. Publications obtained were selected based on methodology, language, date of publication (last 10 years) and relevance. Prospective and retrospective studies, in English or French, review articles; meta-analysis and guidelines were selected and analyzed. This search found 58 articles. After reading, 37 were included in the text based on their relevance.

RESULTS

Frequency of urinary lithiasis in renal transplant recipient is similar to those observed in the general population. Generally, urinary lithiasis of the graft is asymptomatic because of renal denervation after organ procurement and transplantation. Nevertheless, this situation may be at high risk due to the immunosuppressed state of the recipient with a unique functioning kidney. Most of the time, the diagnosis is incidental during routine post-transplantation follow-up. Management of urolithiasis in renal transplant recipient is similar to that performed in general population.

CONCLUSION

Due to its potential severity in transplanted immunosuppressed patients with a sole kidney, urolithiasis requires expert urological management.

摘要

目的

报告器官获取时或肾移植后同种异体肾移植中尿石症的流行病学、特征及其处理情况。

材料与方法

在Medline数据库(http://www.ncbi.nlm.nih.gov)和Embase(http://www.embase.com)中使用以下关键词(医学主题词)的不同组合对科学文献进行详尽的系统综述:尿石症、结石、肾移植。根据方法、语言、出版日期(最近10年)和相关性对获取的出版物进行筛选。选择并分析前瞻性和回顾性研究、英文或法文的综述文章、荟萃分析和指南。该检索共找到58篇文章。阅读后,根据相关性将37篇纳入本文。

结果

肾移植受者中尿石症的发生率与普通人群中观察到的相似。一般来说,由于器官获取和移植后肾去神经支配,移植肾的尿石症通常无症状。然而,由于受者处于免疫抑制状态且仅有一个功能肾,这种情况可能处于高风险。大多数情况下,诊断是在移植后的常规随访中偶然发现的。肾移植受者尿路结石的处理与普通人群相似。

结论

由于尿路结石在单肾移植的免疫抑制患者中可能具有潜在的严重性,因此需要泌尿外科专家进行处理。

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