Risk factors for calculus formation in patients with renal transplants

Harper, James M.; Samuell, C. T.; Hallson, P. C.; Wood, Susan M.; Mansell, M. A.

doi:10.1111/j.1464-410x.1994.tb16576.x

Cited by 91 publications

(57 citation statements)

References 19 publications

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“…Further, transplant kidney stone formers seem to be associated with greater water excretion and more concentrated and alkaline urine. 8 Additionally, cyclosporine is known to result in hyperuricosuria in 50-60% of patients using this medication for immunosuppression, although the incidence of uric acid stones remains low. 9 Despite these risk factors, the reported incidence of stones in transplant kidneys remains low, with published rates of 0.2-1.7%.…”

Section: Discussionmentioning

confidence: 99%

Ex-vivo ureteroscopy of deceased donor kidneys

Machen

Milburn²,

Lowry³

et al. 2017

CUAJ

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Introduction: When encountered, the ideal management of lithiasis in deceased donor kidneys is not well-defined. With advances in endourological techniques, minimally invasive treatments are becoming an increasingly viable option. We set out to describe our experience performing ex-vivo ureteroscopy on cadaveric donor kidneys, including one in which the procedure was completed on-pump. Methods: A retrospective chart review was undertaken to identify patients who had undergone ex-vivo ureteroscopy prior to cadaveric renal transplant. Four patients were identified, including one in which the procedure was done with the kidney remaining onpump. The surgical technique and subsequent data were reviewed. Results: Ex-vivo ureteroscopy was successfully completed in all four instances without intraoperative complication. All kidneys were endoscopically stone-free. Creatinine nadirs ranged from 0.8-1.4. All four patients remained stone-free at a mean followup of 13 months. Conclusions: Our series provides further evidence as to the safety and efficacy of ex-vivo ureteroscopy prior to transplantation in cadaveric renal transplants and describes a novel technique in the form of on-pump ex-vivo ureteroscopy.

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Section: Discussionmentioning

confidence: 99%

Ex-vivo ureteroscopy of deceased donor kidneys

Machen

Milburn²,

Lowry³

et al. 2017

CUAJ

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“…19,20 A metabolic change in the serum and urine of the renal transplant recipient may be a favoring factor for stone development. Hyperparathyroidism, lower citraturia, 9 higher oxaluria, 21 excessive alkaline urine pH, 19 and cyclosporine-induced hyperuricosuria 22 are contributing factors to different types of stone development, namely, calcium oxalate, calcium phosphate, and uric acid stones. In addition, various urologic risk factors have been identified, including infection by urea-splitting microorganisms, voiding dysfunction, retained double J stents, infravesical obstruction, and ureteral obstruction.…”

Section: Discussionmentioning

confidence: 99%

“…1 Urolithiasis is an uncommon sequela after renal transplant with a varying incidence of up to 3%. [2][3][4][5][6][7][8][9] Stones in the allograft may be donor gifted or de novo, which develop after transplant. A donor with a stone-bearing kidney is no longer a contrain dication for donation provided that certain criteria are met, 10 a term called "donor-gifted nephrolithiasis."…”

Section: Introductionmentioning

confidence: 99%

Untitled

2017

Exp Clin Transplant

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Objectives: We report on the long-term follow-up of managing allograft stones at a single tertiary referral institution and review the relevant literature. Materials and Methods: A retrospective analysis of renal allograft recipient charts was performed to identify patients who developed allograft lithiasis between 1974 and 2009. Patient and stone characteristics, diagnoses, treatments, and outcomes were described. Results: Sixteen patients developed 22 stones after a median follow-up of 170 months (range, 51-351 mo). The mean (standard deviation) and median diameter of the stones were 13.8 (8.5) mm and 11 mm. Among these, 3 stones were treated conservatively, 3 by shock-wave lithotripsy, and 7 by cystolitholapaxy. Seven patients underwent percutaneous treatment in the form of percutaneous nephrostomy tube fixation and spontaneous passage of stone (1 stone), shock-wave lithotripsy (1 stone), antegrade stenting (1 stone), and percutaneous nephrolithotomy (6 stones). All patients were stone free after treatment, except for 2 patients whose stones were stable and peripheral on long-term follow-up. Conclusions: Allograft lithiasis requires a multimodal treatment tailored according to stone and graft characteristics. Protocols regarding spontaneous passage can be adopted if there is no harm to the graft and the patient is compliant. Careful attention to the anatomy during percutaneous nephrostomy tube placement is mandatory to avoid intestinal loop injury. A more attentive follow-up is required for early stone management.

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“…9 Transplant recipients are more predisposed to developing urolithiasis due to their conditions such as: hyperfiltration, excessively alkaline urine, renal tubular acidosis, obstructive uropathy, recurrent urinary tract infections, and increased serum calcium caused by persistent tertiary hyperparathyroidism. [10][11][12][13][14] Many series have reported the mean time of posttransplantation lithiasis between 1.6 to 3.6 years. 4,15,16 As, this complication is usually asymptomatic, the diagnosis is often made incidentally by ultrasound examination followed by symptoms such as hematuria, oliguria/anuria, fever, elevated creatinine level, and positive urine culture.…”

Section: Discussionmentioning

confidence: 99%

Tubeless percutaneous nephrolithotomy (pcnl) in renal allografts: a case report and mini-review

et al. 2016

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Urinary lithiasis in transplanted kidney is a relatively uncommon complication. However, it may lead to a significant morbidity and loss of renal function. The report presents the case of a 32-year-old male renal-transplant recipient, with a stone in renal pelvis who was treated successfully by tubeless percutaneous nephrolithotomy (PCNL). The patient is currently stone free with no complication. This article also reviews in brief the treatment of this rare complication. Reviewing the literature showed, it could be noticed that PCNL is a safe and feasible procedure for treating nephrolithiasis in a transplanted kidney.

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Risk factors for calculus formation in patients with renal transplants

Abstract: These results suggest a multifactorial aetiology for stone formation in renal transplant recipients. Approaches to prevention and management are discussed.

Cited by 91 publications

References 19 publications

Ex-vivo ureteroscopy of deceased donor kidneys

Ex-vivo ureteroscopy of deceased donor kidneys

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Tubeless percutaneous nephrolithotomy (pcnl) in renal allografts: a case report and mini-review

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