Kabei Kazuya, Iwai Tomoaki, Kosoku Akihiro, Nishide Shunji, Iguchi Keiko, Machida Yuichi, Naganuma Toshihide, Uchida Junji
Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Transplant Proc. 2023 Oct;55(8):1910-1912. doi: 10.1016/j.transproceed.2023.07.002. Epub 2023 Jul 29.
The patient, a 54-year-old woman, underwent a living donor kidney transplant at Osaka City University Hospital 7 years before the bariatric surgery. Her comorbidities were diabetes, sleep apnea, and severe obesity (weight 103 kg, body mass index [BMI] 36 kg/m), and her diabetes was poorly controlled with an HbA1c of 8.5%. On admission, she weighed 99 kg, BMI was 34 kg/m, Serum creatinine (S-Cre) was 1.54 mg/dL, and HbA1c was 7.1%. A laparoscopic sleeve gastrectomy was performed, and her weight decreased without complications during the perioperative period. She was discharged on postoperative day 28. Two months after surgery, her weight was 87 kg, BMI 30 kg/m, S-Cre 1.34 mg/dL, HbA1c 6.7 %, renal function improved, urine protein decreased, and insulin dosage decreased dramatically. We report this valuable case because there are no reports of bariatric surgery in Japanese renal transplant recipients.
该患者为一名54岁女性，在接受减重手术7年前于大阪市立大学医院接受了活体供肾移植。她的合并症包括糖尿病、睡眠呼吸暂停和重度肥胖（体重103千克，体重指数[BMI]为36千克/平方米），其糖尿病控制不佳，糖化血红蛋白（HbA1c）为8.5%。入院时，她体重99千克，BMI为34千克/平方米，血清肌酐（S-Cre）为1.54毫克/分升，HbA1c为7.1%。进行了腹腔镜袖状胃切除术，围手术期体重下降且无并发症。术后第28天出院。术后两个月，她体重87千克，BMI为30千克/平方米，S-Cre为1.34毫克/分升，HbA1c为6.7%，肾功能改善，尿蛋白减少，胰岛素用量大幅下降。我们报告这一有价值的病例，因为日本肾移植受者中尚无减重手术的相关报道。
