Pochineni Vaishnavi, Rondon-Berrios Helbert
Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
Front Med (Lausanne). 2018 Oct 2;5:261. doi: 10.3389/fmed.2018.00261. eCollection 2018.
Kidney transplantation is the current treatment of choice for patients with end-stage renal disease. Innovations in transplantation and immunosuppression regimens have greatly improved the renal allograft survival. Based on recently published data from the Scientific Registry of Transplant recipients, prevalence of kidney transplants is steadily rising in the United States. Over 210,000 kidney transplant recipients were alive with a functioning graft in mid-2016, which is nearly twice as many as in 2005. While successful renal transplantation corrects most of the electrolyte and mineral abnormalities seen in advanced renal failure, the abnormalities seen in the post-transplant period are surprisingly different from those seen in chronic kidney disease. Multiple factors contribute to the high prevalence of these abnormalities that include level of allograft function, use of immunosuppressive medications and metabolic changes in the post-transplant period. Electrolyte disturbances are common in patients after renal transplantation, and several studies have tried to determine the clinical significance of these disturbances. In this manuscript we review the key aspects of the most commonly found post-transplant electrolyte abnormalities. We focus on their epidemiology, pathophysiology, clinical manifestations, and available treatment approaches.
肾移植是终末期肾病患者当前的首选治疗方法。移植和免疫抑制方案的创新极大地提高了肾移植存活率。根据移植受者科学登记处最近公布的数据，美国肾移植的患病率正在稳步上升。2016年年中，超过21万名肾移植受者存活且移植肾功能良好，这几乎是2005年的两倍。虽然成功的肾移植纠正了晚期肾衰竭中出现的大多数电解质和矿物质异常，但移植后出现的异常与慢性肾病中出现的异常惊人地不同。多种因素导致这些异常的高患病率，包括移植肾功能水平、免疫抑制药物的使用以及移植后的代谢变化。电解质紊乱在肾移植患者中很常见，多项研究试图确定这些紊乱的临床意义。在本手稿中，我们回顾了移植后最常见的电解质异常的关键方面。我们重点关注它们的流行病学、病理生理学、临床表现和可用的治疗方法。
