Clinical usefulness of kidney biopsy in liver transplant recipients with renal impairment
Kidney Research and Clinical Practice
;
: 153-157, 2013.
Article
Dans Anglais
| WPRIM
| ID: wpr-197126
ABSTRACT
BACKGROUND:
Chronic kidney disease is a common complication after liver transplantation. In this study, we analyzed the results of kidney biopsy in liver transplantation recipients with renal impairment.METHODS:
Between 1999 and 2012, 544 liver transplants were performed at our hospital. We retrospectively analyzed the clinical and histological data of 10 liver transplantation recipients referred for kidney biopsy.RESULTS:
The biopsies were performed at a median of 24.5 months (range, 3-73 months) after liver transplantation. The serum creatinine level was 1.81+/-0.5mg/dL at the time of kidney biopsy. There were no immediate complications. The most common diagnosis was glomerulonephritis (GN), such as immunoglobulin A nephropathy (n=4), mesangial proliferative GN(n=1), focal proliferative GN (n=1), and membranous GN (n=1). Typical calcineurin inhibitor (CNI)-induced nephrotoxicity was detected in three cases (30%).Chronic tissue changes such as glomerulosclerosis, interstitial fibrosis, and tubular atrophy were present in 90%, 80%,and 80% of cases, respectively, and mesangial proliferation was detected in 40%of cases. We began treatment for renal impairment based on the result of kidney biopsy; for example, angiotensin-receptor blockers or steroids were prescribed for GN, and the CNI dose was reduced for CNI nephrotoxicity. As a result, eight of 10 patients showed improvement in glomerular filtration rate, but two progressed to end-stage renal disease.CONCLUSION:
Kidney biopsy is a safe and effective method for determining the cause of renal impairment after liver transplantation. Management of patients based on the result of kidney biopsy may improve renal outcomes.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Atrophie
/
Stéroïdes
/
Transplantation
/
Biopsie
/
Fibrose
/
Études rétrospectives
/
Transplantation hépatique
/
Calcineurine
/
Créatinine
/
Diagnostic
Type d'étude:
Etude diagnostique
/
Étude observationnelle
Limites du sujet:
Humains
langue:
Anglais
Texte intégral:
Kidney Research and Clinical Practice
Année:
2013
Type:
Article
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