Calciphylaxis-associated second renal graft failure and patient loss : a case report and review of the literature
OBJECTIVES: Calciphylaxis is a small vessel disease that affects 1% to 4% of patients undergoing dialysis. Only 21 cases of postrenal transplant calciphylaxis have been reported, but none has been associated with primary graft failure or has occurred in a second graft. We present the first case of second renal graft calciphylaxis leading to primary graft failure and death.
MATERIALS AND METHODS: We reviewed the 22 cases, including ours, and assessed risk factors, management, and mortality for these cases.
RESULTS: The mean age was 34.2 -/+ 10.6 years, 11 patients were males (50%), and 13 (57.9%) underwent a deceased-donor renal transplant. The mean pretransplant dialysis period was 35.7 -/+ 39.3 months, 22 patients (100%) were on steroid therapy, 8 (36.4%) had a rejection, 18 (81.8%) underwent postcalciphylaxis parathyroidectomy, and 11 patients died (50%). Acute graft rejection and its management in the presence of high parathormone and divalent ion levels may be associated with postrenal transplant calciphylaxis.
CONCLUSIONS: If the high parathormone levels are not adequately suppressed with medical treatment, prerenal transplant preparation should include parathyroidectomy. In addition, steroids and other immunosuppressive medications should be tapered quickly in calciphylaxis patients, especially if a patient's life is at risk.
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
2008 |
|---|---|
| Erschienen: |
2008 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:6 |
|---|---|
| Enthalten in: |
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation - 6(2008), 4 vom: 01. Dez., Seite 287-93 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Aabed, Gamal [VerfasserIn] |
|---|
| Themen: |
Case Reports |
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| Anmerkungen: |
Date Completed 23.04.2009 Date Revised 31.03.2022 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM187571120 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM187571120 | ||
| 003 | DE-627 | ||
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| 041 | |a eng | ||
| 100 | 1 | |a Aabed, Gamal |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Calciphylaxis-associated second renal graft failure and patient loss |b a case report and review of the literature |
| 264 | 1 | |c 2008 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a Date Completed 23.04.2009 | ||
| 500 | |a Date Revised 31.03.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: Calciphylaxis is a small vessel disease that affects 1% to 4% of patients undergoing dialysis. Only 21 cases of postrenal transplant calciphylaxis have been reported, but none has been associated with primary graft failure or has occurred in a second graft. We present the first case of second renal graft calciphylaxis leading to primary graft failure and death | ||
| 520 | |a MATERIALS AND METHODS: We reviewed the 22 cases, including ours, and assessed risk factors, management, and mortality for these cases | ||
| 520 | |a RESULTS: The mean age was 34.2 -/+ 10.6 years, 11 patients were males (50%), and 13 (57.9%) underwent a deceased-donor renal transplant. The mean pretransplant dialysis period was 35.7 -/+ 39.3 months, 22 patients (100%) were on steroid therapy, 8 (36.4%) had a rejection, 18 (81.8%) underwent postcalciphylaxis parathyroidectomy, and 11 patients died (50%). Acute graft rejection and its management in the presence of high parathormone and divalent ion levels may be associated with postrenal transplant calciphylaxis | ||
| 520 | |a CONCLUSIONS: If the high parathormone levels are not adequately suppressed with medical treatment, prerenal transplant preparation should include parathyroidectomy. In addition, steroids and other immunosuppressive medications should be tapered quickly in calciphylaxis patients, especially if a patient's life is at risk | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 7 | |a Immunosuppressive Agents |2 NLM | |
| 650 | 7 | |a Parathyroid Hormone |2 NLM | |
| 650 | 7 | |a Steroids |2 NLM | |
| 700 | 1 | |a Al Furayh, Othman |e verfasserin |4 aut | |
| 700 | 1 | |a Al-Lehbi, Ali |e verfasserin |4 aut | |
| 700 | 1 | |a Al Mana, Hadeel |e verfasserin |4 aut | |
| 700 | 1 | |a Al Ghamedi, Abdulla |e verfasserin |4 aut | |
| 700 | 1 | |a Helmy, Ahmed |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation |d 2003 |g 6(2008), 4 vom: 01. Dez., Seite 287-93 |w (DE-627)NLM155078615 |x 2146-8427 |7 nnns |
| 773 | 1 | 8 | |g volume:6 |g year:2008 |g number:4 |g day:01 |g month:12 |g pages:287-93 |
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| 952 | |d 6 |j 2008 |e 4 |b 01 |c 12 |h 287-93 | ||