肾移植后的尿酸性肾石病

背景：高尿酸血症是肾移植后常见的并发症之一,其引起的尿酸性肾石病如果治疗不及时可以造成移植肾肾后性失功。目的：探讨肾移植后尿酸性肾石病的诊断和治疗方案。方法：回顾性总结19例肾移植后发生尿酸性肾石病梗阻患者的临床资料,入院时均伴高尿酸血症,8例患者手术切开取石并行输尿管-膀胱再吻合术,11例患者行药物保守治疗。结果与结论：16例患者为移植输尿管下段结石,2例为移植肾肾盂结石并肾盂积水,1例为移植肾重度积水并输尿管全段结石。18例患者治疗后移植肾功能、尿量恢复正常;1例患者造成移植肾失功能,切除移植肾。提示对于肾移植后血尿酸升高患者应尽早应用药物保守治疗,一旦保守治疗无效应及时采取手术方式,减少肾后性原因引起的移植肾失功。

Uric acid nephrolithiasis after renal transplantation

BACKGROUND:Hyperuricemia is a common complication after renal transplantation, if the hyperuricemia caused uric acid nephrolithiasis can not be treated in a timely manner, it may causes the renal allograft loss function after transplantation.OBJECTIVE:To investigate the diagnosis and treatment program of uric acid nephrolithiasis after renal transplantation.METHODS:The data of 19 patients with uric acid nephrolithiasis after renal transplantation were collected for the retrospective summary. All the patients had hyperuricemia, eight patients underwent surgical incision for the stone and received the ureter-bladder re-anastomosis, and 11 patients received the conservative treatment.RESULTS AND CONCLUSION:Sixteen patients had stone at the transplanted lower ureteral, two cases suffered the renal pelvis stone of transplanted renal and hydronephrosis, one case suffered from renal allograft severe hydronephrosis and the entire section of ureteral stone. After treatment, the function and urine output of 18 patients returned to normal; one patient had renal allograft loss function and renal resection. The patients with elevated blood uric acid after renal transplantation should receive the drugs conservative treatment as soon as possible, once the conservative treatment does not work, we should take the surgery way timely in order to reduce postrenal caused renal allograft loss function.