Reversal of Roux-en-Y Gastric Bypass for Successful Salvage of Renal Allograft
| Autor: | Amit D. Tevar, Elizabeth A Moroni, Puneet Sood, Chethan Puttarajappa, Mohamed I. El Hag, Michele Molinari, Armando Ganoza, Martin Wijkstrom, Katherine Hrebinko |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Bariatrics business.industry Gastric bypass General Medicine urologic and male genital diseases medicine.disease Roux-en-Y anastomosis Kidney transplant Gastroenterology Nephropathy surgical procedures operative Internal medicine Renal allograft Medicine business Enteric Hyperoxaluria Complication |
| Zdroj: | The American Surgeon™. 89:1286-1289 |
| ISSN: | 1555-9823 0003-1348 |
| DOI: | 10.1177/0003134821998674 |
| Popis: | Enteric hyperoxaluria (EH) is a known complication of Roux-en-Y gastric bypass (RYGB) and can lead to nephrolithiasis, oxalate-induced nephropathy, and end-stage renal disease. Recurrent EH-induced renal impairment has been reported after kidney transplantation and may lead to allograft loss. EH occurs in up to one quarter of patients following malabsorption-based bariatric operations. We present a report of medically refractory EH in a renal transplant recipient with allograft dysfunction that was successfully managed with reversal of RYGB. The patient developed renal failure 7 years following gastric bypass requiring renal transplant. Following an uneventful living donor kidney transplant, the patient developed recurrent subacute allograft dysfunction. A diagnosis of oxalate nephropathy was made based on biopsy findings of renal tubular calcium oxalate deposition in conjunction with elevated serum oxalate levels and elevated 24-hr urinary oxalate excretion. Progressive renal failure ensued despite medical management. The patient underwent reversal of her RYGB, which resulted in recovery of allograft function. This report highlights an under-recognized, potentially treatable cause of renal allograft failure in patients with underlying gastrointestinal pathology or history of bariatric surgery and proposes a strategy for management of patients with persistent hyperoxaluria based on a review of the literature. |
| Databáze: | OpenAIRE |
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