Rare Complication of Renal Torsion in Autosomal Dominant Polycystic Kidney Disease following an Intraperitoneal Kidney Transplantation.

IF 0.9 Q4 UROLOGY & NEPHROLOGY
Case Reports in Nephrology and Dialysis Pub Date : 2025-06-25 eCollection Date: 2025-01-01 DOI:10.1159/000546881
Olivia C Silveri, Feras Ghosheh
{"title":"Rare Complication of Renal Torsion in Autosomal Dominant Polycystic Kidney Disease following an Intraperitoneal Kidney Transplantation.","authors":"Olivia C Silveri, Feras Ghosheh","doi":"10.1159/000546881","DOIUrl":null,"url":null,"abstract":"<p><p>Autosomal dominant polycystic kidney disease (ADPKD) is present in individuals with chronic renal disease due to bilateral renal cysts. This case report describes the progression of the disease with the rare complication of renal torsion of the transplanted kidney in a patient with ADPKD. To our knowledge, this clinical incidence of renal torsion posttransplant has only been reported in 40 cases in the literature, of which only 3 cases involved ADPKD with two intraperitoneal and one retroperitoneal kidney allograft. The allografts in these 3 cases were salvaged by performing a nephropexy, while our novel case of intraperitoneal renal torsion in ADPKD resulted in loss of allograft viability. A 51-year-old female patient received a living, unrelated donor kidney transplant for end-stage renal disease secondary to ADPKD. She underwent a bilateral native nephrectomy 3 years later. Five years posttransplant, the patient presented to the hospital with significant right lower quadrant abdominal discomfort, oliguria, and nausea. Following admission to the transplant service, she underwent an exploratory laparotomy which revealed a 180-degree counterclockwise torsion of the transplanted intraperitoneal kidney. Renal detorsion was attempted; however, extensive renal infarction occurred, resulting in poor transplant viability. Currently, the patient is undergoing hemodialysis 3 times a week with a plan for re-transplantation when stable. The patient is continuing her immunosuppression regimen and prophylaxis in preparation for a future transplantation. Due to the rare incidence of renal torsion posttransplantation in ADPKD, this study emphasizes the importance of postsurgical imaging and recognizing the symptoms of torsion to avoid loss of allograft viability. Promoting ongoing physician and patient education regarding surgical technique, symptom progression, and imaging protocols posttransplantation is recommended, especially in complex genetic conditions such as ADPKD.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"15 1","pages":"150-160"},"PeriodicalIF":0.9000,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306961/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Nephrology and Dialysis","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000546881","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is present in individuals with chronic renal disease due to bilateral renal cysts. This case report describes the progression of the disease with the rare complication of renal torsion of the transplanted kidney in a patient with ADPKD. To our knowledge, this clinical incidence of renal torsion posttransplant has only been reported in 40 cases in the literature, of which only 3 cases involved ADPKD with two intraperitoneal and one retroperitoneal kidney allograft. The allografts in these 3 cases were salvaged by performing a nephropexy, while our novel case of intraperitoneal renal torsion in ADPKD resulted in loss of allograft viability. A 51-year-old female patient received a living, unrelated donor kidney transplant for end-stage renal disease secondary to ADPKD. She underwent a bilateral native nephrectomy 3 years later. Five years posttransplant, the patient presented to the hospital with significant right lower quadrant abdominal discomfort, oliguria, and nausea. Following admission to the transplant service, she underwent an exploratory laparotomy which revealed a 180-degree counterclockwise torsion of the transplanted intraperitoneal kidney. Renal detorsion was attempted; however, extensive renal infarction occurred, resulting in poor transplant viability. Currently, the patient is undergoing hemodialysis 3 times a week with a plan for re-transplantation when stable. The patient is continuing her immunosuppression regimen and prophylaxis in preparation for a future transplantation. Due to the rare incidence of renal torsion posttransplantation in ADPKD, this study emphasizes the importance of postsurgical imaging and recognizing the symptoms of torsion to avoid loss of allograft viability. Promoting ongoing physician and patient education regarding surgical technique, symptom progression, and imaging protocols posttransplantation is recommended, especially in complex genetic conditions such as ADPKD.

常染色体显性多囊肾病腹膜内肾移植术后少见的肾扭转并发症。
常染色体显性多囊肾病(ADPKD)存在于双侧肾囊肿引起的慢性肾病患者中。本病例报告描述了该病的进展与罕见的并发症肾扭转移植肾的患者ADPKD。据我们所知,文献中仅报道了40例移植后肾扭转的临床发生率,其中只有3例涉及2例腹膜内和1例腹膜后同种异体肾移植的ADPKD。这3例患者的同种异体移植物通过肾固定术得以保存,而我们的新病例是腹腔内肾扭转,导致同种异体移植物丧失活力。一名51岁的女性患者因继发于ADPKD的终末期肾脏疾病接受了活体非亲属供体肾脏移植。3年后,她接受了双侧原生肾切除术。移植后5年,患者就诊时出现明显的右下腹部不适、少尿和恶心。入院后,她接受了剖腹探查术,发现移植的腹膜内肾出现180度逆时针扭转。尝试肾脏扭曲;然而,广泛的肾梗死发生,导致移植生存能力差。目前,患者正在接受血液透析,每周3次,并计划稳定后再次移植。患者正在继续她的免疫抑制方案和预防,为将来的移植做准备。由于肾扭转在ADPKD移植后的发生率很低,本研究强调了术后影像学检查和识别扭转症状的重要性,以避免同种异体移植物活力丧失。建议医生和患者对移植后的手术技术、症状进展和成像方案进行持续的教育,特别是在复杂的遗传条件下,如ADPKD。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
1.20
自引率
0.00%
发文量
36
审稿时长
10 weeks
期刊介绍: This peer-reviewed online-only journal publishes original case reports covering the entire spectrum of nephrology and dialysis, including genetic susceptibility, clinical presentation, diagnosis, treatment or prevention, toxicities of therapy, critical care, supportive care, quality-of-life and survival issues. The journal will also accept case reports dealing with the use of novel technologies, both in the arena of diagnosis and treatment. Supplementary material is welcomed.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信