Yang C W, Lee S H, Choi Y J, Kim Y S, Kim S Y, Choi E J, Chang Y S, Bang B K
Department of Internal Medicine, Catholic University Medical College, Seoul, Korea.
Am J Nephrol. 1997;17(1):42-5. doi: 10.1159/000169070.
The causes of acute renal failure in bacterial allograft pyelonephritis were evaluated using abdominal CT and graft biopsy. Twenty-one recipients, who showed a poor response to antibiotic therapy, comprised this study group. The diagnostic approach taken with this poor responder group was first to perform abdominal CT. If a focal lesion was identified on abdominal CT, a diagnosis of acute focal bacterial nephritis or renal abscess was made. If no focal lesion was found, a graft biopsy was performed for diagnosis. Abdominal CT revealed focal lesions in 9 of the 21 recipients, and renal biopsy showed superimposed acute rejection in 8 of the 12 recipients biopsied. In conclusion, acute renal failure in allograft pyelonephritis is associated with not only severe infection but also a superimposed acute rejection process. Therefore, imaging study and graft biopsy are recommended in the poor responder group.
采用腹部CT和移植肾活检评估细菌性移植肾肾盂肾炎导致急性肾衰竭的原因。本研究组包括21例对抗生素治疗反应不佳的受者。对该反应不佳组采取的诊断方法是首先进行腹部CT检查。如果在腹部CT上发现局灶性病变，则诊断为急性局灶性细菌性肾炎或肾脓肿。如果未发现局灶性病变，则进行移植肾活检以明确诊断。腹部CT显示21例受者中有9例存在局灶性病变，12例接受活检的受者中8例肾活检显示合并急性排斥反应。总之，移植肾肾盂肾炎导致的急性肾衰竭不仅与严重感染有关，还与合并的急性排斥反应过程有关。因此，建议对反应不佳组进行影像学检查和移植肾活检。
