Morioka Fumiyuki, Nakatani Shinya, Mori Katsuhito, Naganuma Toshihide, Yamasaki Takeshi, Uedono Hideki, Tsuda Akihiro, Ishimura Eiji, Uchida Junji, Emoto Masanori
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Japan.
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Japan.
Intern Med. 2024 Sep 15;63(18):2537-2541. doi: 10.2169/internalmedicine.2814-23. Epub 2024 Feb 12.
Thirteen years after kidney donation, a 70-year-old man was referred to a nephrologist because of proteinuria. The serum creatinine, albumin, and urinary protein levels were 2.39 mg/dL, 3.0 g/dL, and 6.72 g/gCr, respectively. A kidney biopsy revealed thickening of the glomerular basement membrane with sub-epithelial deposits, suggesting membranous nephropathy. Considering the apparent interstitial fibrosis and diffuse glomerulosclerosis, supportive treatment was chosen. However, 11 months after the kidney biopsy, hemodialysis was required. The present case constitutes an important teaching point, as glomerular disease can occur in living donors and require careful and long-term medical checkup examinations.
在肾脏捐献13年后，一名70岁男性因蛋白尿被转诊至肾病科医生处。血清肌酐、白蛋白和尿蛋白水平分别为2.39mg/dL、3.0g/dL和6.72g/gCr。肾脏活检显示肾小球基底膜增厚伴上皮下沉积物，提示膜性肾病。考虑到明显的间质纤维化和弥漫性肾小球硬化，选择了支持性治疗。然而，在肾脏活检11个月后，需要进行血液透析。本病例构成了一个重要的教学要点，因为肾小球疾病可发生在活体供体中，需要进行仔细且长期的医学检查。
