Department of Urology, CHU Nantes Hôtel Dieu, 1 Place Alexis Ricordeau, 44000, Nantes, France.
French Urology Association Transplantation Committee, Paris, France.
World J Urol. 2018 Jan;36(1):105-109. doi: 10.1007/s00345-017-2103-8. Epub 2017 Oct 22.
Urolithiasis is rare among renal transplant recipients and its management has not been clearly defined.
This multicentre retrospective study was organised by the Comité de Transplantation de l'Association Française d'Urologie (French Urology Association transplantation committee). Statistical analysis was performed with SPSS 19 software.
Ninety-five patients were included in this study. Renal transplant urolithiasis was an incidental finding in 55% of cases, mostly on a routine follow-up ultrasound examination. One half of symptomatic stones were due to urinary tract infection and the other half were due to an episode of acute renal failure. The initial management following diagnosis of urolithiasis was double J stenting (27%), nephrostomy tube placement (21%), or watchful waiting (52%). Definitive management consisted of: watchful waiting (48%), extracorporeal lithotripsy (13%), rigid or flexible ureteroscopy (26%), percutaneous nephrolithotomy (11%) and surgical pyelotomy (2%). All transplants remained functional following treatment of the stone. The main limitation is the retrospective design.
The incidence of lithiasis could be higher in kidney transplanted patients due to a possible anatomical or metabolical abnormalities. The therapeutic management of renal transplant urolithiasis appears to be comparable to that of native kidney urolithiasis.
肾移植受者中结石病罕见，其治疗方法尚未明确。
这项多中心回顾性研究由法国泌尿外科协会移植委员会组织开展。统计分析采用 SPSS 19 软件。
本研究共纳入 95 例患者。55%的患者为偶然发现肾结石，主要是在常规随访超声检查中发现。有症状的结石一半是由于尿路感染，另一半是由于急性肾衰竭。结石诊断后的初始治疗方案为双 J 支架置入（27%）、肾造瘘管放置（21%）或密切观察（52%）。明确的治疗方案包括：密切观察（48%）、体外碎石术（13%）、硬性或软性输尿管镜检查（26%）、经皮肾镜取石术（11%）和肾盂切开术（2%）。所有移植肾在治疗结石后仍保持功能。主要的局限性在于回顾性设计。
由于可能存在解剖或代谢异常，肾结石的发病率在肾移植受者中可能更高。肾移植后肾结石的治疗管理似乎与原肾肾结石相似。
