Téma:  Case Studies

Patient after kidney transplantation – a multidisciplinary problem

Jaroslav Rosenberger, Beáta Grejtovská, Michal Hulman, Albert Hermely, Jana Jevčáková, Ján Lepej, Juraj Podracký, Robert Roland, Zuzana Semanová, Norbert Torma, Helena Vargová

Though kidney transplantation is the method of choice in treatment of chronic renal failure, transplanted patients have high morbidity and mortality caused mainly by cardiovascular diseases and infections. This case report presents a 45-year-old patient 4.5 years after kidney transplantation from a cadaveric donor. The patient had already been treated for hypertension during dialysis period, had suffered an anterolateral non-Q myocardial infarction and had had his left hand little finger amputated for gangrene in calciphylaxia. Hypercalcaemia caused by numerous parathyroid gland adenomas occurred after transplantation in September 2002; it required repeated surgical removal (2004, 2005). Thrombosis of the left humeral artery and vein was diagnosed in 2006 with the need for surgical thrombectomy and prosthetic replacement. The patient suffered from infectious endocarditis of the aortic valve caused by Enterococus faecalis and subsequent ischemic stroke. After an aortal valve prosthesis was implanted, the patient developed acute transplant kidney injury. After conservative treatment, kidney function returned to its previous status. At the present time the patient is stabilized, without manifestations of heart failure and his creatininaemia is within the range 140-150 µmol/l.

Ročník 2007  Témy časopisu Internal medicine 5 / 2007

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prof. MUDr. Peter Mitro, PhD.
doc. MUDr. Viliam Mojto, CSc., MHA
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prof. MUDr. Juraj Payer, CSc., FRCP
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prof. MUDr. Igor Riečanský, DrSc.
doc. MUDr. Ján Staško, PhD.
doc. MUDr. Mária Szántová, PhD.
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