Pediatric urologyDysfunction of lower urinary tract in renal transplant children with nephrologic disease
Section snippets
Material and methods
With permission of the Medical Ethics Committee of Radboud University Nijmegen, data were gathered from January to May 2003 using a written questionnaire, free uroflowmetry, transabdominal ultrasonography, frequency volume chart, and the children’s medical records. The questionnaire we used was based on the Bristol Female Lower Urinary Tract Symptoms questionnaire.11, 13 In this instrument, LUTS are defined from the patient’s perspective. The patient or the caregiver can describe the symptoms.
Characteristics
Table I shows the characteristics of the study group (n = 21). Eight children underwent bilateral nephrectomy and one unilateral nephrectomy. Three children underwent preemptive transplantation and therefore did not need renal replacement therapy. Eight children underwent peritoneal dialysis and 10 children hemodialysis before renal transplantation. Five children received their transplant from a living, related donor and 16 children from a postmortem donor. The mean age at transplantation was
Comment
We studied the effects of dysfunction of the lower urinary tract on transplant function in renal transplant children with an underlying nephrologic disease. We found substantial negative relationships between the Ccr at study and PVR urine volume, sensation of incomplete emptying, and UTI. To determine whether these associations were not just an effect of graft age or an initial low Ccr, OLS regression analyses were performed. Our results have made clear that both PVR urine volume (P = 0.03)
Conclusions
A PVR urine volume and UTIs after renal transplantation may result in renal transplant deterioration in children with an underlying nephrologic disease.
References (24)
- et al.
Role of the bladder in delayed failure of kidney transplants in boys with posterior urethral valves
J Urol
(2000) - et al.
Results of renal transplantation in boys treated for posterior urethral valves
J Urol
(1993) - et al.
Long-term bladder dysfunction and renal function in boys with posterior urethral valves based on urodynamic findings
J Urol
(2004) - et al.
Urinary tract infections following renal transplantation
Transplant Proc
(1998) - et al.
Lower urinary tract symptoms after renal transplantation in children
J Urol
(2006) - et al.
Myogenic failure in posterior urethral valve diseasereal or imagined?
J Urol
(2002) - et al.
Estimating normal bladder capacity in children
J Urol
(1997) - et al.
Better long-term functional adaptation to the child’s size with pediatric compared to adult kidney donors
Kidney Int
(2002) - et al.
Can ultrasonography or uroflowmetry predict which children with voiding dysfunction will have recurrent urinary tract infections?
J Urol
(2005) - et al.
Long-term outcome of boys with posterior urethral valves
Br J Urol
(1988)
Long term results of pediatric renal transplantation into a dysfunctional lower urinary tract
Transplantation
Urinary tract infection in patients with urological complications after renal transplantation with respect to long-term function and allograft survival
Ann Transplant
Cited by (14)
Lower Urinary Tract Symptoms in Children and Adolescents With Chronic Renal Failure
2010, Journal of UrologyCitation Excerpt :In children with nonurological disorders we found a surprisingly high frequency of LUTS (59%), which to our knowledge has not been reported previously. Since LUTS may be a risk factor for UTI after transplantation, and recurrent UTIs constitute a risk of deterioration of graft function, LUTS should be recognized as an important variable in all pre-transplant investigations, not just in children with urological disorders.5,6 In the nonurological disorders group 10 of 27 patients (37%) had a large bladder capacity.
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