Wednesday, 4 June 2008

renal transplantation

exam question:
patient with renal transplant and arteriovenous fistula,did not had palpable kidneys.
what are the causes of renal failure?
discussion about polycystic kidney disease(presentation/complications)

Polycystic kidney disease:
AD chromosome 16
Prevalence 1:1000
The third most common cause of CRF in the UK

see presentation below.
what are the most used immunosuppresive medications and its saide effects?


  1. long-term drug treatment for the prevention of rejection is employed in all cases apart from living related donation from an identical twin.
    Adverse effects include suppression of red cell and platelet production, an increased incidence of infections (particularly viral), and hepatotoxicity.
    other side effects:
    hypersensitivity reactions,dose-related bone marrow suppression,liver impairment, cholestatic jaundice and hair loss.
    Its introduction has revolutionized organ transplantation. Disadvantages include high cost and nephrotoxicity.
    other side effects:
    gastro-intestinal disturbances, gingival hyperplasia, hepatic dysfunction, anorexia; hypertension; tremor and headache.
    calcineurin inhibitor
    Its side-effects are broadly similar to those of CSA except it is more diabetogenic
    synergistic with CSA but lack nephrotoxicity
    Its main side-effects are thombocytopenia and hyperlipidaemia.

  2. complications of renal transplant:
    1-opportunistic infections
    2-premature coronary artery disease
    4-lymphoma/skin cancer
    6-complications of steroid therapy

  3. complications of APKD:
    renal complications:
    1-lion pain
    5-renal failure
    extrarenal complications:
    cystic: cysts in other organs (liver, ovary,pancreas,spleen)
    GIT:colonoic diverticulae

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