In this case, you may be given a medication that numbs only a small area of your body (local anesthesia) in the radiology department. Sometimes, the first step of the procedure is performed in the radiology department. With general anesthesia, you won't be awake for the procedure and you won't feel any pain. Percutaneous nephrolithotomy is usually performed in the hospital under general anesthesia. Your surgeon may prescribe antibiotics to reduce your chance of developing an infection after the procedure. In some cases, you may need to stop these medications before your surgery. Let your care team know about all of the medications, vitamins and dietary supplements you're taking. You may be instructed to stop eating and drinking after midnight on the night before your procedure. Urine and blood tests check for signs of infection or other problems, and a computerized tomography (CT) scan shows where the stones are in your kidney. A proper metabolic evaluation should be conducted to diagnose specific, treatable metabolic disorders, thereby reducing the frequency of recurrent stone disease in these conditions as well.The most common risks from percutaneous nephrolithotomy include:īefore percutaneous nephrolithotomy, you will have several tests. Five different models of stone formation can be identified, depending on stone composition, risk of infection stones, and pathogenesis of renal cystic and malformative conditions. Indeed, metabolic abnormalities have been observed in the majority of stone-forming patients with conditions such as horseshoe kidney and ureteropelvic junction obstruction. However metabolic factors are also important in the pathogenesis of stones in these conditions. Urinary stasis is generally assumed to play a major part in the pathogenesis of the nephrolithiasis associated with distorted renal anatomy due to a delayed washout of crystals and risk of urinary infections. The prevalence of renal stones in renal cystic and malformative conditions exceeds the prevalence of renal stones in the general population, suggesting that the above-mentioned cystic and malformative disorders favor stone formation. Immediate recognition is critical to restore renal allograft function and to treat associated serious infection in an immunocompromised patient. Conclusion: Although a rare complication, urolithiasis in an allograft can be associated with significant morbidity. Based on the stone analysis and history of urinary tract infections with urease splitting bacteria, the calculus was thought to be infection-induced. After undergoing an emergency nephrostomy and treatment of sepsis, a staghorn calculus was subsequently removed by percutaneous nephrolithotomy. Sixteen years after transplant, she presented with Gram-negative sepsis with Proteus mirabilis and acute anuric renal failure in the allograft. Methods and Results: A 48-year-old Caucasian female, with end-stage renal disease due to autosomal dominant polycystic kidney disease, underwent cadaveric renal transplantation in 1986. We report a case of a staghorn calculus occurring in renal allograft, presenting as anuric renal failure with Gram-negative sepsis. Background: Urolithiasis is a rare complication in renal transplant recipients.
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