LO STENT INTERNO-ESTERNO COME STRUMENTO DIAGNOSTICO PER L’IDENTIFICAZIONE PRECOCE DELLA GLOMERULOSCLEROSI FOCALE SEGMENTALE NEI RICEVENTI IL TRAPIANTO DI RENE

Research output: Other contribution

Abstract

[automatically translated] Introduction: The focal segmental glomerulosclerosis (FSGS) is one of the most frequent diseases glomerualri recurring after kidney transplantation (15-100%). This study evaluates the usefulness of the internal-external stent as a diagnostic tool to monitor proteinuria after kidney transplantation in patients with FSGS in our center. Materials and methods: It 'was carried out a retrospective analysis of 11 recipients of kidney transplantation (7 from relatives living donor, 4 cadaveric) between 2000 and 2008 with biopsy-proven FSGS who were subjected to stenting indoor-outdoor intraoperative. All patients had a urine output ≥ 500 ml. A feeding tube from 6 Fr pediatric nutrition has been used as a stent and placed in the ureter of the transplanted kidney and steriorizzato through the bladder to the abdominal wall. It was carried out the examination of the urine of 12 hours daily for the study of protein / creatinine. The stent was removed at the third week. Results: The mean age at diagnosis of FSGS was 42 years (3-57). The mean interval from the histological diagnosis of FSGS kidney failure terminal was 3.9 years (1-8). Two patients had FSGS ricorrente.Un patient presented simultaneously acute rejection of grade 1 b proved by biopsy. The other patients had proteinuria (> 3g) in the first post-operative day suggesting plasmapheresis. The biopsy showed FSGS recurring. Proteinuria lasted a year and a half and then lead to kidney failure. To re-transplant was placed a stent inside-out, and no recurrence was not demonstrated. To there is no recurrence of FSGS in 9 patients mean follow-up of 2 years. The average creatinine has values of 1.44 mg / dl (0.9 to 2.8 mg / dl), and the average ratio protein / creatinine was 0.96 (0.1-2). Conclusion: the positioning of the outside inside the stent in the kidney is useful as a diagnostic tool to assess the early recurrence of FSGS after kidney transplantation as a preventive measure in patients with urine output in the native kidney. The long-term outcomes are improved with the identification and treatment
Original languageItalian
Publication statusPublished - 2009

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