捐献肾脏13年后,一名70岁的男子因蛋白尿被转介给肾病医生。血清肌酐,白蛋白,尿蛋白水平为2.39mg/dL,3.0g/dL,和6.72g/gCr,分别。肾活检显示肾小球基底膜增厚,上皮下沉积,提示膜性肾病.考虑到明显的间质纤维化和弥漫性肾小球硬化,选择支持治疗。然而,肾活检11个月后,需要血液透析。本案构成了一个重要的教学点,因为肾小球疾病可能发生在活体捐赠者中,需要仔细和长期的体检。
Thirteen years after kidney donation, a 70-year-old man was referred to a nephrologist because of proteinuria. The serum creatinine, albumin, and urinary protein levels were 2.39 mg/dL, 3.0 g/dL, and 6.72 g/gCr, respectively. A kidney biopsy revealed thickening of the glomerular basement membrane with sub-epithelial deposits, suggesting membranous nephropathy. Considering the apparent interstitial fibrosis and diffuse glomerulosclerosis, supportive treatment was chosen. However, 11 months after the kidney biopsy, hemodialysis was required. The present
case constitutes an important teaching point, as glomerular disease can occur in living donors and require careful and long-term medical checkup examinations.