Decreased proteinuria following liver transplantation in a patient with type C liver cirrhosis complicated with nephrotic syndrome: a case report.
Type C liver cirrhosis is often associated with a nephrotic syndrome secondary to membranoproliferative glomerulonephritis. Liver transplantation in such patients may sometimes worsen viremia, causing renal dysfunction upon the introduction of immunosuppressive drugs. We present a case of a patient whose proteinuria decreased after liver transplantation. The patient was a 49-year-old male who had been followed due to chronic hepatitis type C from 1984. From 1999 he was diagnosed as having nephrotic syndrome. We performed a living related liver transplant on August 21, 2001. An intraoperative renal biopsy revealed the histology to show membranoproliferative glomerulonephritis. The volume of proteinuria was 2 to 11 g/day before surgery. After surgery it varied from 6 to 10 g/day, gradually decreasing to 1 to 2 g/day. One of the causes of reduced proteinuria may be alleviation of membranoproliferative glomerulonephritis by immunosuppression. But from the view that the recovery of the renal function followed the recovery of liver function, the major effect may have been alleviated hepatorenal syndrome.
Kato
T
T
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Sato
Y
Y
Yamamoto
S
S
Takeishi
T
T
Hirano
K
K
Kobayashi
T
T
Hara
Y
Y
Watanabe
T
T
Shirai
Y
Y
Hatakeyama
K
K
D001706:Biopsy; D016174:Hepacivirus / Q000302:isolation & purification; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007668:Kidney / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009404:Nephrotic Syndrome / Q000150:complications* / Q000473:pathology; D011507:Proteinuria / Q000453:epidemiology*; D012333:RNA, Messenger / Q000235:genetics; D012367:RNA, Viral / Q000097:blood / Q000302:isolation & purification; D016896:Treatment Outcome
D012333:RNA, Messenger; D012367:RNA, Viral