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CASE REPORT
Year : 2016  |  Volume : 10  |  Issue : 2  |  Page : 49-51

Renal allograft dysfunction secondary to ureterolithiasis: Diagnosis and management


1 Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Rai Bareilly Road, Lucknow 226014, Uttar Pradesh, India
2 Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Rai Bareilly Road, Lucknow 226014, Uttar Pradesh, India
3 Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Rai Bareilly Road, Lucknow 226014, Uttar Pradesh, India

Correspondence Address:
Hira Lal
Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Rai Bareilly Road, Lucknow 226014, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.1016/j.ijt.2016.03.011

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Urolithiasis is one of the most common conditions seen in urology practice. Renal transplantation is associated with a lower incidence of urolithiasis compared to general population. In these patients, the incidence of isolated ureteric calculi is 5–10 times lower than renal calculi. If renal and/or ureteric calculi are present in transplanted kidney, they must be attended urgently as the presentation in such patients is atypical due to lack of sympathetic innervation of the graft kidney and the condition may rapidly progress to graft dysfunction. The diagnosis of renal and upper ureteric calculi is usually made on graft ultrasonography. For mid and distal ureteric calculi, CT and MR urography are more sensitive. For nonobstructive calculi, treatment is with extracorporeal shock wave lithotripsy (ESWL) or flexible ureteroscopic removal for smaller stone burden (<1.5 cm) while obstructive calculi and larger stones are best addressed with percutaneous nephrostomy followed by percutaneous nephrolithotomy (PCNL) or ESWL or endoscopic removal.


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