Projects / Programmes
Some complication after renal transplantation - diagnosis and follow-up
| Code |
Science |
Field |
Subfield |
| 3.06.00 |
Medical sciences |
Cardiovascular system |
|
| Code |
Science |
Field |
| B560 |
Biomedical sciences |
Urology, nephrology |
renal transplantation, complications, ultrasound, diagnostics, vesicouretheral reflux, renal artery stenosis, urolithiasis
Researchers (11)
Organisations (1)
Abstract
The common purpose of our studies is to improve diagnostic accuracy and evaluate long-term influence of some complications after renal transplantation on longterm graft function. The complications we intend to deal with are vesicouretheral reflux, renal transplant artery stenosis, urolithiasis in renal graft and graft failure in early postoperative period.
Vesicouretheral reflux is frequent complication after renal transplantation and a possible cause of recurrent urinary tract infection. In previous study we have introduced contrast enhanced voiding urosonography as a new method replacing standard methods for diagnosing reflux (classical roentgen voiding or isotope voiding cystography). In further study we intend to improve its diagnostic accuracy by performing the procedure in cyclic manner (first and second voiding).
Renal transplant artery stenosis in one of the most demanding complications, both diagnostically as well as therapeutically. Gold standard for diagnosisis is renal angiography, which is unsuitable as a screening or follow-up test. In previous study we have established firm Doppler criteria for diagnosing stenosis and also for its follow-up. In further study we intend to improve the way for evaluating hemodynamic significance of stenosis of different level. We intend to evaluate captopril Doppler study in patients with stenosis and compare it to losartan Doppler study, which according to preliminary report from isotope studies, can further improve diagnostic accuracy. Also longterm follow-up of exact site of stenosis will help us to assess the natural progression of this condition (which according to our preliminary data seems to be less than previously thought). Data from this part of the study will help us in decision making when to intervene.
In last years intensive manage of posttransplant osteoporosis became a part of standard posttransplant management of renal transplant patients. Therapy of osteoporosisi often includes calcitriol and calcium orally. We have observed urolithiasis/calcinations in some patients with such therapy. The aim of this part of study is to report the incidence and influence on renal graft function and urinary tract infection rate of this, relatively rare complication.
Sudden anuria in early posttransplant period demand urgent diagnosis and intervention. The aim of this part of study is to evaluate value of bedside emergency ultrasound/Doppler examination in detecting cause of graft failure and its value as a main guide for intervention.
