同種腎移植における自己患腎の摘除の意義

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  • EVALUATION OF BILATERAL NEPHRECTOMY IN RENAL ALLOTRANSPLANTS
  • ドウシュ ジン イショク ニ オケル ジコ カン ジン ノ テキジョ ノ イギ

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The effects of bilateral nephrectomy at the time of renal transplantation, which were performed at the Kinki University Hospital, the Osaka University Hospital and the Nishinomia Prefectural Hospital, were evaluated. The following results were obtained.<br>1) In cases of nephrectomized patients, their blood pressure depends mainly on graft function. For example, when a patient had creatinine level of below 2.5mg/dl three months after grafting, his blood pressure remained within almost normal range but a patient was hypertensive if creatinine level over 2.5mg/dl.<br>2) The anephric patient who has lost graft function and returned to hemodialysis program showed remarkable hypotension, furthermore when graft was removed erythrocytes counts decreased.<br>3) The patient who had high blood pressure in spite of successful renal transplantation the PRA value elevated constantly and the patient whose graft function had been lost had almost normal PRA value, but the PRA level decreased remarkably, when the graft was removed.<br>4) Serum erythropoietin value was correlated inversely with the graft function (r=-0.65), and correlated with the number of erythrocytes (r=0.75). These results suggest that the bilateral nephrectomy in renal allotransplantation should be performed on limited patients with indication.

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