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Abstract

Objectives: Successful kidney transplant depends partly on the normal physiologic functioning of the bladder, which involves effective urine storage and emptying. The bladder may become abnormal owing to various urologic and neuropathic disorders. Patients with abnormal bladders need careful management before and after transplant. In this study, we aimed to determine the outcomes of renal transplants in relation to various causes of abnormal bladder. Materials and Methods: We conducted a retrospective review of 25 patients with abnormal bladder who received 30 renal transplants between 1990 and 2014. The patients were divided into neurologic and urologic groups based on the causes of abnormal bladder. Patient demographics, graft function, survival, and postoperative complications were compared. Results: The most common urologic cause was posterior urethral valve (14 patients), while the most common neurologic cause was spina bifida (6 patients). There was no statistically significant difference in graft survival at 1, 3, and 5 years between patients with neurologic and urologic causes of abnormal bladder as well as at long-term follow-up. However, the mean estimated glomerular filtration rate at 1, 3, and 5 years was higher among patients with neurologic causes than in those with urologic causes, although the difference was statistically significant only at 1 year (61 ± 34 vs 37 ± 19 mL/min; P = .025). Stone formation was reported only in patients whose abnormal bladder had neurologic causes, and no incidence was reported in patients with urologic causes (20% vs 0%; P = .038). The incidence of other postoperative complications was not statistically significant between the 2 groups. Conclusions: With careful evaluation and proper preoperative correction of abnormal bladder dysfunction and optimization of the emptying and storage functions of the bladder, the causes of abnormal bladder did not appear to impact graft function and survival or overall rate of postoperative complications.

Clean Intermittent Catheterization in Children under 12 Years Does Not Have a Negative Impact on Long-Term Graft Survival following Pediatric Kidney Transplantation

“…CIC commonly leads to bacteriuria [ 12 ]. Bacteriuria combined with immunosuppression following pediatric kidney transplantation is assumed to be a risk factor for the development of febrile UTIs or could even lead to sepsis, which could affect long-term graft survival or even patient survival [ 13 , 14 , 15 ]. In our study, we retrospectively reassessed all cases of children under twelve years of age undergoing CIC following pediatric kidney transplantation in our center and asked, from a retrospective point of view, whether CIC had a possible impact on the long-term graft survival or the overall patient survival of young child recipients.…”