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KMID : 0361120020160010057
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Korean Journal of Transplantation
2002 Volume.16 No. 1 p.57 ~ p.61
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Hematuria in Renal Transplant Patients: Causes and Diagnostic Algorithm
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이종훈*,∥/Jong Hoon Lee*,∥
김순일*,†/김유선*,†/권기환*,†/박기일*,†/나군호‡/양승철‡/홍순원§/정현주§/김현정*/전경옥*/Soon Il Kim*,†/Yu Seun Kim*,†/Ki Hwan Kwon*,†/Ki Il Park*,†/Koon Ho Rha‡/Seung Choul Yang‡/Soon Won Hong§/Hyeon Joo Jeong§/Hyun Jung Kim*/Kyung Ock Jeo
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Abstract
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Purpose: Hematuria is a frequently encountered clinical problem in kidney graft recipients. The causes are variable, may be benign or malignant, but imperative to affect long-term graft function and survival. We have evaluated renal
recipients
who had hematuria using a newly defined algorithm.
Methods: We evaluated 1060 renal transplant recipients from March 1, 1992 to February 28, 2000. In 93 recipients, hematuria was transitory and spontaneously resolved within 3 months. We tried to identify the cause of persistent hematuria
in
126
recipients. Patients were evaluated with plain x-ray, sonography, cystoscopic examination and/or graft biopsy.
Results: The mean duration of hematuria onset after transplantation was 17.81±14.6 months (4∼70 months). The causes of gross hematuria were urolithiasis (n=15), benign bladder mucosal bleeding (n=3), bladder cancer (n=2) and kidney
cancer
from
an original kidney (n=1). Graft kidney biopsies were performed in 96 patients and the results were as follows: chronic rejection in 18, IgA nephropathy in 16, cyclosporine toxicity in 8, acute rejection in 5, focal segmental glomerulosclerosis in
3, the
other glomerulonephritis in 2, and tubular atrophy and interstitial fibrosis in 19 patients. Combined pathologic findings were detected in 15 patients. In 8 patients, no pathological diagnoses were made. We were unable to evaluate 9 patients due
to
patient's refusal.
Conclusion: The causes of hematuria after kidney transplantation are variable from benign to malignant disease. If the cause of hematuria is uncertain on ultrasonographic examination, cystoscopic examination and/or graft biopsy should be
performed for making a definite diagnosis.
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