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Treatment of recurrent renal transplant lithiasis: analysis of our experience and review of the relevant literature.
BMC Nephrol. 2020 Jun 23; 21(1):238.BN

Abstract

BACKGROUND

Renal transplant lithiasis is a rather unusual disease, and the recurrence of lithiasis presents a challenging situation.

METHODS

We retrospectively analyzed the medical history of one patient who suffered renal transplant lithiasis twice, reviewed the relevant literature, and summarized the characteristics of this disease.

RESULTS

We retrieved 29 relevant studies with an incidence of 0.34 to 3.26% for renal transplant lithiasis. The summarized incidence was 0.52%, and the recurrence rate was 0.082%. The mean interval after transplantation was 33.43 ± 56.70 mo. Most of the patients (28.90%) were asymptomatic. The management included percutaneous nephrolithotripsy (PCNL, 22.10%), ureteroscope (URS, 22.65%), extracorporeal shockwave lithotripsy (ESWL, 18.60%) and conservative treatment (17.13%). In our case, the patient suffered from renal transplant lithiasis at 6 years posttransplantation, and the lithiasis recurred 16 months later. He presented oliguria, infection or acute renal failure (ARF) during the two attacks but without pain. PCNL along with URS and holmium laser lithotripsy were performed. The patient recovered well after surgery, except for a 3 mm residual stone in the calyx after the second surgery. He had normal renal function without any symptoms and was discharged with oral anticalculus drugs and strict follow-up at the clinic. Fortunately, the calculus passed spontaneously about 1 month later.

CONCLUSIONS

Due to the lack of specific symptoms in the early stage, patients with renal transplant lithiasis may have delayed diagnosis and present ARF. Minimally invasive treatment is optimal, and the combined usage of two or more procedures is beneficial for patients. After surgery, taking anticalculus drugs, correcting metabolic disorders and avoiding UIT are key measures to prevent the recurrence of lithiasis.

Authors+Show Affiliations

Department of Hepatobiliary Surgery, First Affiliated Hospital, China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China.Department of Hepatobiliary Surgery, First Affiliated Hospital, China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China.Department of Hepatobiliary Surgery, First Affiliated Hospital, China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China.Department of Hepatobiliary Surgery, First Affiliated Hospital, China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China.Department of Hepatobiliary Surgery, First Affiliated Hospital, China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China.Department of Urology, First Affiliated Hospital, China Medical University, No.155, Nanjing North Street, Shenyang, 110001, Liaoning Province, People's Republic of China.Department of Urology, First Affiliated Hospital, China Medical University, No.155, Nanjing North Street, Shenyang, 110001, Liaoning Province, People's Republic of China.Department of Hepatobiliary Surgery, First Affiliated Hospital, China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China. jlz2200@126.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32576135

Citation

Li, Xiaohang, et al. "Treatment of Recurrent Renal Transplant Lithiasis: Analysis of Our Experience and Review of the Relevant Literature." BMC Nephrology, vol. 21, no. 1, 2020, p. 238.
Li X, Li B, Meng Y, et al. Treatment of recurrent renal transplant lithiasis: analysis of our experience and review of the relevant literature. BMC Nephrol. 2020;21(1):238.
Li, X., Li, B., Meng, Y., Yang, L., Wu, G., Jing, H., Bi, J., & Zhang, J. (2020). Treatment of recurrent renal transplant lithiasis: analysis of our experience and review of the relevant literature. BMC Nephrology, 21(1), 238. https://doi.org/10.1186/s12882-020-01896-5
Li X, et al. Treatment of Recurrent Renal Transplant Lithiasis: Analysis of Our Experience and Review of the Relevant Literature. BMC Nephrol. 2020 Jun 23;21(1):238. PubMed PMID: 32576135.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of recurrent renal transplant lithiasis: analysis of our experience and review of the relevant literature. AU - Li,Xiaohang, AU - Li,Baifeng, AU - Meng,Yiman, AU - Yang,Lei, AU - Wu,Gang, AU - Jing,Hongwei, AU - Bi,Jianbin, AU - Zhang,Jialin, Y1 - 2020/06/23/ PY - 2020/01/28/received PY - 2020/06/15/accepted PY - 2020/6/25/entrez PY - 2020/6/25/pubmed PY - 2020/6/25/medline KW - Calculus KW - Recurrence KW - Renal transplant lithiasis KW - Transplanted kidney stone KW - Treatment SP - 238 EP - 238 JF - BMC nephrology JO - BMC Nephrol VL - 21 IS - 1 N2 - BACKGROUND: Renal transplant lithiasis is a rather unusual disease, and the recurrence of lithiasis presents a challenging situation. METHODS: We retrospectively analyzed the medical history of one patient who suffered renal transplant lithiasis twice, reviewed the relevant literature, and summarized the characteristics of this disease. RESULTS: We retrieved 29 relevant studies with an incidence of 0.34 to 3.26% for renal transplant lithiasis. The summarized incidence was 0.52%, and the recurrence rate was 0.082%. The mean interval after transplantation was 33.43 ± 56.70 mo. Most of the patients (28.90%) were asymptomatic. The management included percutaneous nephrolithotripsy (PCNL, 22.10%), ureteroscope (URS, 22.65%), extracorporeal shockwave lithotripsy (ESWL, 18.60%) and conservative treatment (17.13%). In our case, the patient suffered from renal transplant lithiasis at 6 years posttransplantation, and the lithiasis recurred 16 months later. He presented oliguria, infection or acute renal failure (ARF) during the two attacks but without pain. PCNL along with URS and holmium laser lithotripsy were performed. The patient recovered well after surgery, except for a 3 mm residual stone in the calyx after the second surgery. He had normal renal function without any symptoms and was discharged with oral anticalculus drugs and strict follow-up at the clinic. Fortunately, the calculus passed spontaneously about 1 month later. CONCLUSIONS: Due to the lack of specific symptoms in the early stage, patients with renal transplant lithiasis may have delayed diagnosis and present ARF. Minimally invasive treatment is optimal, and the combined usage of two or more procedures is beneficial for patients. After surgery, taking anticalculus drugs, correcting metabolic disorders and avoiding UIT are key measures to prevent the recurrence of lithiasis. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/32576135/Treatment_of_recurrent_renal_transplant_lithiasis:_analysis_of_our_experience_and_review_of_the_relevant_literature L2 - https://www.biomedcentral.com/1471-2369/21/238 DB - PRIME DP - Unbound Medicine ER -
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