慢性腎不全の合併症と腎移植

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タイトル別名
  • Recovery from Various Complications in Chronic Renal Failure Following Renal Allotransplantation
  • マンセイ ジンフゼン ノ ガッペイショウ ト ジン イショク ニョウドクショウ
  • ―尿毒症性末梢神経症・骨異栄養症,甲状腺機能などの改善について―

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説明

This study was performed to analyse recovery process of various complications in chronic renal failure with successful renal transplantation. Twenty patients were treated renal allograft from living donors from March, 1975 to April, 1978. Sixteen patients who have good renal function with the serum creatinine less than 2.5 mg%, were examined in uremic neuropathy, uremic osteodystrophy, anemia, thyroid function test and sweating abnormality before and after renall transplantation. Motor nerve conduction velocity (NCV) was reduced in 7 cases out of 15 before transplantation. All cases expect one, recovered into the normal range in NCV within 2 months, A severely damaged patient took 3 years to normalize in NCV. Serum calcium and phosphate levels became normal within several days after transplantation. Serum alkaline phosphatase became abnormally high between 3 months and one year after transplantation. Accompaniing this finding, the bone uptake of Tc 99 m diphosphonate (Bone scan) became prominent. The recovery from the bone disease took 1 to 1.5 years by bone scan. The rentogenological improvement seems to need more time. There were no improvement of vascular calcification and atherosclerotic change under the observation up to 2 years, The levels of parathormone (PTH) which were high in 5 cases out of 11 before transplantation became normal one day to 3 months after transplantation. Anemia and uremic skin color were recovered between 1 and 3 months after transplantation. Thyroid function tests which were performed before transplantation, were compatible with subclinical hypothyroidism. Free thyroxine indices which were in the low normal range before, went up in the middle of the normal range within 1-6 months after transplantation, Disturbed perspiration became normal within one to 3 months. These data indicate that early transplantation is recommended if a patient has uremic neuropathy, osteodystrophy, vascular calcification and/or atherosclerotic changes, because of the retarded or irreversible recovery from them with successful renal transplantation.

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