Bladder Augmentation Can be Problematic With Renal Failure and Transplantation

Alfrey, Edward J.; Salvatierra, Oscar; Tanney, Diana C.; Mak, Robert H.; Scandling, John D.; Dafoe, Donald C.; Hammer, Gregory B.; Orlandi, Pamela; Page, Leigh; Conley, Susan B.

doi:10.1016/s0022-5347(01)62327-9

Cited by 8 publications

(10 citation statements)

References 6 publications

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“…This may have been due to favorable bladder dynamics, most importantly a low pressure, compliant reservoir. In the 2 patients who had progression to ESRD average time to renal replacement therapy was twice the interval previously hypothesized by Alfrey et al 14 Our conclusions support the practice of augmentation before transplantation. In addition to stabilized or improved native kidney function, several other advantages of pretransplant augmentation should be considered.…”

Section: Discussionsupporting

confidence: 81%

See 1 more Smart Citation

Progression of Renal Insufficiency in Children and Adolescents With Neuropathic Bladder is Not Accelerated by Lower Urinary Tract Reconstruction

et al. 2010

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Section: Discussionsupporting

confidence: 81%

“…Some groups argue that even moderate renal insufficiency is a relative contraindication to augmentation since it may hasten ESRD. 14 We studied the progression rate of renal insufficiency in patients with severe lower urinary tract dysfunction and evaluated whether the deterioration rate is affected by augmentation.…”

mentioning

confidence: 99%

Progression of Renal Insufficiency in Children and Adolescents With Neuropathic Bladder is Not Accelerated by Lower Urinary Tract Reconstruction

et al. 2010

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“…There are conflicting reports on the management of the lower urinary tract before and after transplantation. Alfrey et al reported that bladder augmentation before transplant caused increasing hydronephrosis and infection and sug- Values are given as mean ± standard error unless indicated otherwise gested takedown of bladder augmentation before transplant [20]. Other studies, however, have shown that urinary tract reconstruction before transplantation is safe [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Chronic kidney disease in the VACTERL association: clinical course and outcome

et al. 2009

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Approximately 60% of VACTERL (vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula with atresia, renal defects/radial limb dysplasia) patients have renal anomalies that can be associated with chronic kidney disease (CKD). With improved medical care, a large proportion of these patients survive into adulthood. Longitudinal follow-up data regarding the management of kidney disease in these children is lacking. Twelve VACTERL patients with CKD stage 2-5 and 12 age-matched controls with similar urologic anomalies and CKD [mean follow-up period 15.0 +/- 1.4 (SE) and 11.9 +/- 2.1 years, respectively] were identified in a single center. Eight VACTERL patients progressed to end-stage renal disease (ESRD) compared to four controls (66.7 vs. 33.3%, respectively). Six VACTERL patients were dialyzed pre-transplant. Of the four patients on peritoneal dialysis (PD), three had to be switched to hemodialysis due to complications, whereas two of the three controls on PD did not experience significant problems. Seven VACTERL patients underwent renal transplantation compared to four controls. Mean creatinine clearance 2 years post-transplant was 65.8 +/- 6.3 in VACTERL patients vs. 87.8 +/- 7.1 ml/min per 1.73 m(2) in controls (p = 0.03). VACTERL patients had a significantly lower mean height standard deviation score than the controls (-2.34 +/- 0.41 vs. -1.27 +/- 0.24, respectively; p < 0.05). Based on these results, VACTERL patients with CKD develop ESRD more frequently, experience more complications with dialysis, may have a poorer transplant outcome, and have more severe growth failure than controls.

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“…Our UUTD system also narrows the span between grade III and IV. Ninety-five ureters with UUTD, 96 ureters with VUR and 61 patients with chronic renal failure had a midterm It is widely accepted that significant renal impairment is a more controversial relative contraindication to AE [2,13]. A recent report suggested that AE does not hasten the progression of renal insufficiency in NBD patients [14].…”

Section: Discussionmentioning

confidence: 99%