P8.113: Starting a New Life Thanks to a Successful Kidney Transplant After 30 Years of Hemodialysis: Case Report

Abstract

Introduction: Chronic kidney disease (CKD) has devastating effects, especially on children. Complications that develop secondary to chronic kidney disease at an early age may negatively affect the remaining period of the patient. As is known, the only curative treatment for CKD is kidney transplantation (KT). Thanks to KT in a short time after the diagnosis of CKD, the development of complications can be prevented or the complications can be recovered. In our study, we evaluated our patient who had CKD since the age of 7 and had a kidney transplant at our center after 30 years. Methods: Our patient, who did not have any disease before, was given beta lactam antibiotic therapy for pneumonia at the age of 7 years. After the treatment, the patient developed peripheral edema and decreased urine output. In the examinations performed for these reasons, the patient was diagnosed with drug-induced nephritis and hemodialysis treatment (HD) was started. After 1.5 years of HD, a peritoneal dialysis catheter was inserted for the purpose of peritoneal dialysis. However, 20 days after the peritoneal dialysis catheter was placed, the patient underwent laparotomy due to intraperitoneal bleeding. 4 days after the first laparotomy, the patient underwent a repeat laparotomy due to acute appendicitis and appendectomy was performed. In the following period, the patient received HD 3 times a week. In addition, the patient developed calcium deficiency and growth retardation. Skeletal deformities, dwarfism and dental deformities developed in the patien. In addition, the patient was infected with the hepatitis C virus due to blood transfusion. After the patient admitted to our center for treatment, all medical treatments of the patient were revised and he was added to the waiting list because he did not have a suitable donor. The bladder capacity was determined as 10 cc. Hydrodilatation was applied to the patient in order to expand the bladder volume. KT from a decased donor was performed by our team on January 06, 2022. Results: No complications were observed in the patient during the KT and in the postoperative period. On the 7th postoperative day, the patient had a urine output of approximately 5000 cc/day. Thanks to the previous hydrodilations, the bladder capacity has reached a satisfactory and comfortable level. The creatinine level of the patient decreased to 1.02 mg/dL on the 3rd postoperative day. The serum calcium level increased to 10.7 mg/dL after KT. The hemoglobin level increased from 7 g/dL to 13 g/dL. Conclusion: Kidney transplantation is the only treatment option to return to healthy life, especially for patients diagnosed with chronic kidney disease at an early age. Thanks to early successful kidney transplants in experienced centers, patients can lead a comfortable life socially and medically.