[Renal sarcoidosis with a pseudotumoral pyelic localization]. / Sarcoïdose rénale avec localisation pyélique pseudo-tumorale.

BACKGROUND: Renal sarcoidosis exceptionally presents as a unilateral pyelic pseudotumor as in this case where it was associated with granulomatous nephropathy. CASE REPORT: A 33-year-old man had a two-year history of systemic sarcoidosis with no renal involvement. He developed renal failure related to interstitial granulomatous nephropathy associated with a pyelic localization leading to unilateral hydronephrosis. Urine drainage associated with corticosteroid therapy provided a favorable course. DISCUSSION: Renal involvement in sarcoidosis is usually the consequence of hypercalcemia and hypercalciuria related to ectopic secretion of calcitriol by the sarcoidosic granulomas, with urinary lithiasis and nephrocalcinosis leading to renal failure and also granluomatous interstitial nephropathy. Glomerulopathy or obstructive nephropathy are rarely reported. Intraluminal localizations such as the pyelic lesion in our case are exceptional but must be detected early since they respond to corticosteroid therapy.

[Bilateral nephrectomy before renal transplantation in autosomal dominant polycystic renal disease]. / Néphrectomie bilatérale en un temps avant transplantation rénale dans la polykystose rénale autosomique dominante.

Patients with autosomal dominant polycystic kidney disease are good candidates for renal transplantation, despite the fact that they are older at initiation of dialysis treatment. After grafting, the native polycystic kidneys are, however, at risk of infectious and hemorrhagic complications, in addition to patient's discomfort and technical difficulties with graft placement. We report on 10 successful cases of pretransplant binephrectomy performed in one time and analyse the risk factors of such a surgery. Nowadays, it appears that the disadvantages of an anephric state can be balanced by substitutive therapy. In conclusion, after this short series, we think that bilateral nephrectomy has to be considered in patients with autosomal polycystic kidney disease, especially when they have a prior history of renal infections and/or repeated hematurias.

[Discovery of an undetected thrombosis of the artery of the graft during kidney transplantation. Value of resolution of the obstruction and high pressure kidney washing]. / Découverte lors d'une transplantation rénale d'une thrombose méconnue de l'artère du greffon. Intérêt de la désobstruction et du lavage rénal à forte pression.

During the transplantation of a kidney, we have discovered an undetected recent thrombosis of the renal artery of the graft, which was revealed after clamp removal by infarction of the kidney. We performed an immediate arterial desobstruction and a secondary high flow rate washing of the kidney, which allowed properly restoring the vascularity of the graft and successfully grafting it.

[Syndrome of the pyelo-ureteral junction of the graft after kidney transplantation. Apropos of 2 cases]. / Syndrome de la jonction pyélo-urétérale du greffon après transplantation rénale. A propos de 2 cas.

We report 2 cases of decompensation of a pelviureteric obstruction in a transplanted kidney. In one case, the pyeloureteral obstruction was discovered intraoperatively during grafting (cadaver kidney) and was corrected at that time. In the other case, the obstruction was decompensated one month after grafting (kidney taken from a living donor with a very discrete bilateral junction syndrome) and required surgical treatment. The procedure used in both cases was a pyelopyelic anastomosis after nephrectomy of the recipient's kidney.