Sudden late onset of gross hematuria in a previous renal transplant recipient 3 months after transplant nephrectomy.
Causes of gross hematuria in a patient with end-stage renal disease are limited compared with those in patients with normal renal function. Given the increased likelihood of patients with end-stage renal disease developing renal cell carcinoma, the workup focuses on a careful evaluation of the collecting system. The workup for gross hematuria in a renal transplant recipient is similar; however, the focus shifts toward a more thorough evaluation of the transplanted kidney and bladder because immunosuppression increases the overall risk for malignancy. An immunosuppressed patient also is at risk for infectious processes in the transplanted kidney manifesting as gross hematuria. Concerns for chronic rejection also should be investigated, although microscopic hematuria is more common in this scenario. If this is unrevealing, then close scrutiny of the native kidneys for possible sources of bleeding is warranted. We present an interesting and unusual cause of painless gross hematuria in a patient with end-stage renal disease and transplant nephrectomy 3 months before the onset of bleeding.
Nanovic
Lisa
L
Department of Transplant Surgery, University of Wisconsin, Fitchburg, WI 53713, USA.
Becker
Yolanda Tai
YT
Hedican
Sean
S
Hofmann
R Michael
RM
D001739:BK Virus; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D005402:Fistula / Q000150:complications* / Q000628:therapy; D006084:Graft Rejection / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D006417:Hematuria / Q000209:etiology* / Q000628:therapy; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000601:surgery / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009393:Nephritis / Q000175:diagnosis; D027601:Polyomavirus Infections / Q000150:complications; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D012077:Renal Artery / Q000601:surgery*; D006435:Renal Dialysis; D013536:Suture Techniques; D013927:Thrombosis / Q000188:drug therapy / Q000517:prevention & control; D014412:Tumor Virus Infections / Q000150:complications; D014548:Urinary Fistula / Q000150:complications* / Q000628:therapy; D014571:Urologic Neoplasms / Q000175:diagnosis; D014636:Valsalva Maneuver; D014652:Vascular Diseases / Q000150:complications* / Q000628:therapy; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use; D014891:Weight Lifting
D014859:Warfarin