Hematuria in Renal Transplant Recipients

Previte, Steven R.; Murata, Gary T.; Olsson, Carl A.; Schmitt, G; Nabseth, Donald C.; Cho, Sang I.

doi:10.1097/00000658-197802000-00021

Cited by 19 publications

(16 citation statements)

References 17 publications

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“…Only few reports describing the frequency and possible causes of haematuria following kidney transplantation have been published in the literature [1][2][3]. In contrast to the previous reports, in which a majority of causes identified were associated with nonmalignant conditions, the most prevalent cause contributing to persistent haematuria in our series was urological malignancy (42.2%) including one superficial bladder UC, one invasive bladder UC, 16 patients with upper urinary tract UC (ureter/renal pelvis) and one adenocarcinoma of urachus.…”

Section: Discussionmentioning

confidence: 99%

“…They reported an incidence of 12% in 127 male kidney transplant recipients and inflammatory conditions accounted for half of the cases. Three patients with acute rejection episodes also presented with gross haematuria, but no urological malignancy was found in their series [1]. In 2002, Butani et al.…”

Section: Introductionmentioning

confidence: 99%

“…Haematuria following kidney transplantation was first addressed by Previte et al in 1978. They reported an incidence of 12% in 127 male kidney transplant recipients and inflammatory conditions accounted for half of the cases.…”

Section: Introductionmentioning

confidence: 99%

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High incidence of urinary tract malignancy among patients with haematuria following kidney transplantation in Taiwan

Tai¹,

Lai²,

Wang³

et al. 2009

Transplant International

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Haematuria is a common complication following kidney transplantation, but few studies describing post-transplant haematuria have been published. Herein, we investigated the incidence and etiologies of persistent hematuria with kidney transplant patients in Taiwan. The medical records of 189 kidney transplant recipients with functioning grafts were retrospectively reviewed. Any episode of haematuria during routine follow-up was recorded and evaluated. The patient characteristics, possible causes of haematuria and consequent managements were reviewed. Among the 189 patients, 44 patients (23.3%) experienced 45 episodes of persistent haematuria during routine monthly follow-up at our transplant clinic. Thirty-two episodes (71%) were microscopic haematuria and 13 (29%) were gross haematuria. The most prevalent etiology explained for the persistent haematuria in our series was urologic malignancy (19 patients, 42.2%), followed by urinary tract infections (24.5%) and unexplained reasons (17.8%). Furthermore, those patients with persistent haematuria caused by urologic malignancy were also associated with significantly longer duration following transplantation and worse graft function. Haematuria is frequently seen in kidney transplant recipients and the most prevalent cause in our series is urologic malignancy. Those patients were also associated with significantly poorer graft function; however, the mechanism is still unclear.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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High incidence of urinary tract malignancy among patients with haematuria following kidney transplantation in Taiwan

Tai¹,

Lai²,

Wang³

et al. 2009

Transplant International

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“…The main presenting symptom in the present patients and in other reports was painless haematuria [8,10,11]. Although haematuria among the transplant population might have several other causes [22], it should be vigorously investigated, with emphasis on the use of urine cytology, endoscopy and imaging, to exclude malignancy.…”

Section: Discussionmentioning

confidence: 99%

Bladder carcinoma among live‐donor renal transplant recipients: a single‐centre experience and a review of the literature

et al. 2007

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OBJECTIVES To present our experience with bladder cancer among a renal transplant population and to review critically the relevant literature. PATIENTS AND METHODS In all, 1865 renal graft recipients were followed for a mean (sd) of 6.5 (5) years. Seven recipients (all men) developed a urothelial bladder tumour. The stage and grade of the tumours were determined. The method of the treatment was selected on the basis of the tumour characteristics and graft function. Patients were regularly followed; the endpoints were cancer‐specific survival, recurrence or metastasis. RESULTS All patients presented with gross haematuria. There was non‐muscle‐invasive disease in two patients who were treated by transurethral resection and adjuvant intravesical bacille Calmette‐Guérin immunotherapy. One patient died 24 months later due to complications of end‐stage renal disease. To date the second patient is alive and free of the recurrence. Five recipients with muscle‐invasive disease had a radical cystectomy and orthotopic bladder substitution. The mean (sd) time to the last follow‐up or death was 14.6 (3.1) months. Three patients died with stable graft function; two from distant metastasis and one from a cerebrovascular stroke. The remaining two patients are still alive, free of disease and with good graft function. CONCLUSIONS Urothelial bladder tumours are generally uncommon. The presence of haematuria in renal allograft recipients should be thoroughly investigated. Early diagnosis and prompt treatment are required for managing such tumours, because they are aggressive. Orthotopic bladder substitution is feasible with a good functional outcome for patients in whom cystectomy is indicated.

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“…Microscopic or macroscopic hematuria is seen in 12% of patients after kidney transplantation, which is about 15 times higher than that in the general population. 7 We should always pay attention to hematuria to avoid pitfalls in the early detection of urothelial malignancies in kidney recipients.…”

Section: Discussionmentioning

confidence: 99%

Synchronous bilateral urothelial cancer in a kidney recipient

Nakazawa¹,

Miyano²,

Sasaki³

et al. 2011

Int J of Urology

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Synchronous bilateral urothelial cancer is very rare. We report a 25-year-old male kidney recipient with Alport syndrome who developed bilateral synchronous urothelial cancer after transplantation. At the age of 16 this patient was referred to our clinic for a kidney transplantation. A living related donor kidney transplantation was performed with cyclosporin-based quadruple immunosuppression. He experienced no acute rejection and his graft function was excellent after transplantation. Nine years after transplantation, he complained of asymptomatic gross hematuria and was diagnosed as having a bilateral urothelial cancer in the native upper urinary tracts. A bilateral total nephroureterectomy was undertaken, and the postoperative pathological diagnosis was advanced bilateral urothelial carcinoma. The patient received adjuvant gemcitabine plus cisplatin chemotherapy at a cisplatin dosage reduced by 50%. After 4 years of followup, he is alive with a functioning graft and no evidence of recurrence.

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Hematuria in Renal Transplant Recipients

Cited by 19 publications

References 17 publications

High incidence of urinary tract malignancy among patients with haematuria following kidney transplantation in Taiwan

High incidence of urinary tract malignancy among patients with haematuria following kidney transplantation in Taiwan

Bladder carcinoma among live‐donor renal transplant recipients: a single‐centre experience and a review of the literature

Synchronous bilateral urothelial cancer in a kidney recipient

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