[Incidence and treatment of urinary lithiasis in renal transplantation].
BACKGROUND
Urinary calculi is an uncommon complication in kidney transplantation; several stone risk factors are found in transplanted patients, but in most cases there is not a relationship between these risk factors and stone formation. The treatment of these patients is complex due to their both immunosuppressive status and border-line renal function.


METHODS
From 1980 to February 2000, 1198 kidney transplant have been performed in our institution. We describe our series consisting in 22 urinary calculi (15 in the graft, 3 in the urether and 4 in the bladder) in 18 patients, including 7 stones detected in cadaveric donor patients.


RESULTS
We performed external shock wave lithotripsy in 7 patients, bench surgery in 4, endoscopic mechanic lithotripsy in 5, open surgery in 1 and observation in 6. Calcium oxalate (mono and dihidrate) was found in 9 of 13 calculi. Metabolic changes were found in 15 of the 18 patients, the most common was hiperuricemia. There were not complications of every treatment applied and 9% of them needed a savage treatment. We found recurrence in 4 cases (22.2%). Now 12 of the patients are stone-free (66.7%) and three have non-significative stones (83.3% without symptoms).


CONCLUSIONS
Detection of renal calculi in cadaveric renal donors is not a reason to refuse the graft for further transplantation. In both renal calculi up to 2 cm and uretheric calculi surgical treatment is assessed as first option. In caliceal stones smaller than 5 mm observations is the best treatment.
Torrecilla Ortiz
C
C
Servicio de Urología, Ciudad Sanitaria y Universitaria de Bellvitge, Hospitalet de Llobregat, Barcelona.
González-Satué
C
C
Riera Canals
L
L
Colom Feixas
S
S
Franco Miranda
E
E
Aguilo Lucía
F
F
Serrallach Mila
N
N
D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D012189:Retrospective Studies; D014545:Urinary Calculi / Q000453:epidemiology* / Q000628:therapy*
Incidencia y tratamiento de la litiasis urinaria en el injerto renal.