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Erschienen in:
06.06.2017 | Clinical Quiz
Abdominal distention and continuous feeding intolerance after intraperitoneal kidney transplant: Answers
Erschienen in: Pediatric Nephrology | Ausgabe 4/2018
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1.
The differential diagnosis for abdominal distention and allograft dysfunction after kidney transplant is broad. The following is a noncomprehensive list of possible etiologies underlying the problem.
a)
Ascites secondary to:
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Recurrence of nephrotic syndrome due to circulating anti-nephrin antibodies
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Acute allograft rejection
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Severe pancreatitis
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Post-operative urinary leak
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Ruptured subcapsular lymphocele
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Portal hypertension following renal transplant
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Allograft renal vein stenosis
-
Chylous ascites
-
Innate renal allograft pathology
b)
Gastroparesis and ileus
c)
Peritonitis with or without ascites
2.
Recurrence of nephrotic syndrome secondary to de novo formation of anti-nephrin antibodies
3.
a)
Complete abdominal ultrasound with Doppler
b)
Renal function test
c)
Tacrolimus level
d)
Donor-specific antibody tests
e)
Urinalysis with spot urine protein-to-creatinine ratio
f)
Plasma anti-nephrin antibody test
g)
Renal biopsy
4.
Treatment with intravenous steroids, rituximab, and plasmapheresis