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Reversal of Roux-en-Y Gastric Bypass for Successful Salvage of Renal Allograft
- Source :
- The American Surgeon™. 89:1286-1289
- Publication Year :
- 2021
- Publisher :
- SAGE Publications, 2021.
-
Abstract
- 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.
- Subjects :
- 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
Subjects
Details
- ISSN :
- 15559823 and 00031348
- Volume :
- 89
- Database :
- OpenAIRE
- Journal :
- The American Surgeon™
- Accession number :
- edsair.doi.dedup.....1cbd8bb5055d8e5608c3a4d0b02a0133