Kidney Ultrasound Is Useful Tool in Posttransplant Follow-Up

Objectives: Renal sonography has been an important imaging tool in surveys of kidney diseases. We reviewed our experience in the finding and management of asymptomatic patients who underwent renal transplantation. Methods: We performed baseline graft and native kidney sonography after renal transplantation, as well as annually even if the patient was asymptomatic. At the end of 2004, a total of 326 transplant cases had been annually surveyed. If the findings were positive, they were compared with previous data to determine the need for further examinations and management. Results: The native kidneys of 105 patients were abnormal. Cysts were detected in 71 cases, 23 of which were bilateral. Stones were found in 15 cases. Polycystic kidney disease was identified in 5. The findings in these 91 patients were the same as before. Moderate hydronephrosis was observed in 14 cases. Nine had native ureteral cancer and underwent nephroureterectomy. Ureteral stricture was found in the other 5 patients. Forty-five grafts were abnormal. Thirty-one showed hydronephrosis and 2 underwent ureteral reimplantation. Asymptomatic stones were found in 2. A new single renal cyst was found in 2 cases; and multiple cysts in one other. Elevated RI on color Doppler was discovered in 12 patients, 4 of whom lost their grafts this year. Serum creatinine values of 6.9 and 2.2 mg/dL were observed in 2 patients. Conclusions: Renal sonography screening is useful not only for the graft but also for the native kidney. Hydronephrosis is an important finding. The high possibility of urothelial malignancy should be expected, requiring further examination and sequential follow-up. Elevated RI is a clue to predict graft outcome; rapid deterioration was observed within months.