Kabler R L, Cerny J C
J Urol. 1983 Mar;129(3):475-8. doi: 10.1016/s0022-5347(17)52188-6.
We investigated 112 patients with end stage renal disease. Clinical evaluations included cystoscopy, cystometry, voiding cystography, bilateral retrograde pyelograms, history and physical examination, and appropriate serum and urinary studies. Of the 112 patients 28 (25 per cent) had significant abnormalities of the urinary tracts. Of the 28 patients 17 had lower tract abnormalities, such as detrusor hyporeflexia, obstructing prostatic hyperplasia and urethral stricture, and 11 had upper tract disease, 9 of whom required a pre-transplant surgical procedure. Included in the group of 9 patients were those with polycystic kidneys, staghorn calculi, renin-related renal hypertension, chronic pyelonephritis and persistent vesicoureteral reflux. None of the azotemic patients had significant morbidity with the timing of the surgical procedures. We believe that eradication of such conditions in the pre-transplant period resulted in a more suitable candidate for renal transplantation. Furthermore, we believe that our finding of 25 per cent abnormalities underscores the need for early urologic evaluation of these patients to ensure their functional capabilities as a recipient.
我们对112例终末期肾病患者进行了调查。临床评估包括膀胱镜检查、膀胱测压、排尿性膀胱造影、双侧逆行肾盂造影、病史及体格检查，以及适当的血清和尿液检查。112例患者中，28例（25%）存在显著的尿路异常。28例患者中，17例存在下尿路异常，如逼尿肌反射减退、梗阻性前列腺增生和尿道狭窄，11例存在上尿路疾病，其中9例需要在移植前进行手术。9例患者包括多囊肾、鹿角形结石、肾素相关肾性高血压、慢性肾盂肾炎和持续性膀胱输尿管反流患者。氮质血症患者在手术时机方面均无显著并发症。我们认为，在移植前消除这些病症可使患者更适合接受肾移植。此外，我们认为25%的异常率这一发现强调了对这些患者进行早期泌尿外科评估的必要性，以确保其作为受者的功能能力。
