Renal Transplant Hydroureteronephrosis as a Manifestation of Rejection: An Under-Recognized Entity?

Hydroureteronephrosis (HUN) of the renal transplant (RT) can be obstructive or non-obstructive, refluxing or non-refluxing, and can cause allograft dysfunction. HUN of the RT as a manifestation of rejection is uncommon and has not been described in children. We describe two pediatric RT recipients who presented with late-onset HUN, 5 and 10 years after transplantation. Both had new-onset HUN which occurred at the time of rejection; HUN resolved in both patients after treatment of rejection. Renal function stabilized in both patients without the need for stent or nephrostomy tube placement. There was no obstruction or vesicoureteral reflux (VUR). Edema of the uroepithelial cells leading to transient obstruction causing HUN is a most likely explanation. We conclude that treatment of rejection in patients without obstruction or VUR may lead to resolution of HUN without the need for urological interventions.

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PUK6 POST RENAL TRANSPLANT PATIENT SURVIVAL AND THE COMBINED ADVERSE EFFECT OF POOR RENAL FUNCTION AND NEW ONSET DIABETES MELLITUS

Value in Health ◽

10.1016/s1098-3015(11)73022-4 ◽

2010 ◽

Vol 13 (7) ◽

pp. A474

Author(s):

P McEwan ◽

K Baboolal

Keyword(s):

Diabetes Mellitus ◽

Adverse Effect ◽

Renal Function ◽

Renal Transplant ◽

Renal Transplant Patient ◽

Transplant Patient ◽

Patient Survival ◽

Poor Renal Function ◽

New Onset Diabetes Mellitus ◽

New Onset

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Serum Endocan Levels Associated with Hypertension and Loss of Renal Function in Pediatric Patients after Two Years from Renal Transplant

International Journal of Nephrology ◽

10.1155/2016/2180765 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Livia Victorino de Souza ◽

Vanessa Oliveira ◽

Aline Oliveira Laurindo ◽

DelmaRegına Gomes Huarachı ◽

Paulo Cesar Koch Nogueira ◽

...

Keyword(s):

Blood Pressure ◽

Renal Function ◽

Renal Transplant ◽

Published Data ◽

Hemodynamic Variables ◽

Pediatric Renal Transplant ◽

Positive Correlations ◽

Pediatric Rt ◽

Important Marker

Endocan is an important biomarker of inflammation and endothelial dysfunction that increases in association with several chronic diseases. Few published data have described the role of endocan in pediatric renal transplant (RT) patients. We evaluated the endocan concentrations in 62 children who underwent renal transplantation and assessed their relationships with the patients’ blood pressure and loss of renal function. The endocan levels were significantly elevated in the pediatric RT patients who had hypertension and a loss of renal function. We determined positive correlations between the endocan concentrations and the hemodynamic variables (systolic blood pressure:r=0.416;P=0.001; pulse pressure:r=0.412;P=0.003). The endocan levels were inversely correlated with the estimated glomerular filtration rate (r=-0.388;P=0.003). An endocan cutoff concentration of 7.0 ng/mL identified pediatric RT patients who had hypertension and a loss of renal function with 100% sensitivity and 75% specificity. In conclusion, the endocan concentrations were significantly elevated in pediatric RT patients who had both hypertension and a loss of renal function. The correlations between the endocan levels and the hemodynamic variables and the markers of renal function strengthen the hypothesis that it is an important marker of cardiorenal risk.

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Case 7.31

Mayo Clinic Body MRI Case Review ◽

10.1093/med/9780199915705.003.0192 ◽

2014 ◽

pp. 364-365

Author(s):

Christine U. Lee ◽

James F. Glockner

Keyword(s):

Renal Function ◽

Renal Transplantation ◽

Renal Transplant ◽

Cardiac Function ◽

Focal Segmental Glomerulosclerosis ◽

Signal Intensity ◽

Diffuse Alveolar Hemorrhage ◽

Lower Quadrant ◽

Right Lower Quadrant ◽

New Onset

19-year-old man with recent renal transplantation for focal segmental glomerulosclerosis who now has declining renal function and new-onset diffuse alveolar hemorrhage and reduced cardiac function Axial SSFSE images (Figure 7.31.1) reveal diffuse increased signal intensity throughout the featureless right lower quadrant renal transplant. Axial postgadolinium 2D SPGR images (...

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Percutaneous treatment of obstructive uropathy in renal transplant recipients: outcomes of nephrostomy tube placement within and after 30 days of transplantation

Indian Journal of Transplantation ◽

10.1016/j.ijt.2014.12.034 ◽

2014 ◽

Vol 8 (4) ◽

pp. 108-112 ◽

Cited By ~ 1

Author(s):

A. Uflacker ◽

D. Sheeran ◽

M.G. Khaja ◽

J. Patrie ◽

G. Elias ◽

...

Keyword(s):

Renal Transplant ◽

Obstructive Uropathy ◽

Percutaneous Treatment ◽

Tube Placement ◽

Renal Transplant Recipients ◽

Nephrostomy Tube ◽

Transplant Recipients

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Abstract No. 192 Rethinking time-to-exchange: outcomes of nephrostomy tube placement in pregnancy

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2021.03.198 ◽

2021 ◽

Vol 32 (5) ◽

pp. S84-S85

Author(s):

S. Kapoor ◽

D. Maldow ◽

A. Sharma

Keyword(s):

Tube Placement ◽

Nephrostomy Tube ◽

In Pregnancy

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Rapid nephrostomy tube placement using a CT guided single stick system

Academic Radiology ◽

10.1016/s1076-6332(97)80394-7 ◽

1997 ◽

Vol 4 (12) ◽

pp. 866

Author(s):

Mark E. Bohlman ◽

Ron Khazan ◽

Fintan Regan

Keyword(s):

Tube Placement ◽

Nephrostomy Tube ◽

Ct Guided

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Twelve-month effects of everolimus on renal and lung function in lung transplantation: differences in chronic lung allograft dysfunction phenotypes

Therapeutic Advances in Chronic Disease ◽

10.1177/2040622321993441 ◽

2021 ◽

Vol 12 ◽

pp. 204062232199344

Author(s):

Filippo Patrucco ◽

Elias Allara ◽

Massimo Boffini ◽

Mauro Rinaldi ◽

Cristina Costa ◽

...

Keyword(s):

Renal Function ◽

Lung Function ◽

Lung Transplant ◽

Bronchiolitis Obliterans Syndrome ◽

Forced Expiratory Volume ◽

Chronic Lung Allograft Dysfunction ◽

Allograft Dysfunction ◽

Transplant Patients ◽

Restrictive Allograft Syndrome ◽

Trend Data

Background: Chronic lung allograft dysfunction (CLAD), a complication affecting the survival of lung transplanted patients, includes two clinical phenotypes: bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS). Everolimus is used in CLAD because of its antiproliferative mechanism. In lung transplant patients treated with everolimus, the clinical course of renal and lung function has not yet been assessed systematically in CLAD, BOS and RAS patients for more than 6 months. Methods: We retrospectively evaluated the 12-month follow-up of renal and lung function of lung-transplanted patients switched to everolimus and evaluated the reduction in immunosuppressant dosage (ISD) and mortality. Subgroups were based on indication for everolimus treatment: CLAD and non-CLAD patients, BOS and RAS among CLAD patients. Results: We included 26 patients, 17 with CLAD (10 BOS, seven RAS). After 1 year from the everolimus switch, we observed renal function improvement (serum creatinine −17%, estimated glomerular filtration rate +24%) and stable pulmonary function [forced expiratory volume in the first second (FEV1) −0.5%, forced vital capacity (FVC) +0.05%]. RAS patients had progressive functional loss, whereas BOS patients had FEV1 improvement and FVC stability. All-cause mortality was higher in the CLAD versus non-CLAD group (41% versus 11%), without differences between BOS and RAS patients ( p > 0.05). All patients had significant and persistent ISD reduction. Conclusion: Lung transplant patients treated with everolimus had improvements in renal function and reduced ISD. We observed sustained improvements in lung function for CLAD related to BOS subgroup results, whereas RAS confirmed the 1-year worsening functional trend. Data seem to suggest one more piece of the puzzle in CLAD phenotyping.

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