Urological Complications in Pediatric Renal Transplantation

Nuininga, Jody; Feitz, W. F. J.; Dael, K.C. van; Gier, R.P.E. de; Cornelissen, Elisabeth A.M.

doi:10.1159/000052510

Cited by 47 publications

(29 citation statements)

References 17 publications

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“…In the review of the literature of the last 5 years, the experience with RT in patients with PUV is not provided specifically but included in large series of patients with malformative and dysfunctional abnormalities of the lower urinary tract, with some authors considering that they show differences in terms of graft survival [17] and urological complications [18,19] and others that they do not show differences in their clinical course [20,21] from groups without lower urinary tract disease. These differences in clinical course may be related to the different origin of the donor, with a living donor being used in some series, and to the varied urological management performed pre-and posttransplantation.…”

Section: Discussionmentioning

confidence: 99%

Renal transplantation in children with posterior urethral valves

Mendizábal¹,

Zamora²,

Serrano

et al. 2006

Pediatr Nephrol

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The objective of this study was to analyze whether renal transplantation (RT) in children with posterior urethral valves (PUV) constitutes a special group with respect to groups with different etiologies of end-stage renal disease (ESRD). Between 1979 and 2004, 22 RT were performed in 19 children with PUV. The median age at RT was 10 years (range: 1.3-17). Immunosuppression was provided by triple therapy and polyclonal/monoclonal antibodies. This group was compared with the two control groups: (1) glomerulopathy (n=62) and (2) pyelonephritis/dysplasia (n=42) without lower urinary tract disease, transplanted in the same period. Ten graft losses occurred in 22 transplants: thrombosis (2), acute rejection (3), chronic graft nephropathy (2), and death of patients (3) with a functioning graft in the 1st postoperative month. We did not find significant differences versus the control group in renal function or probability of graft or patient survival at 1, 5, and 10 years. We observed a greater risk of urological complication in patients with PUV. RT with PUV constitutes a special group due to the compulsory young age and the need for careful and complex medicosurgical management; nevertheless, the results achieved were similar to those obtained in our general RT population.

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Section: Discussionmentioning

confidence: 99%

Renal transplantation in children with posterior urethral valves

Mendizábal¹,

Zamora²,

Serrano

et al. 2006

Pediatr Nephrol

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“…Not used risk for postoperative vesico-ureteral reflux problems even after surgical repair (11,12). Pediatric post-transplant hydronephrosis has correlated with worsening renal function and increased incidence of pyelonephritis, necessitating more aggressive preoperative and postoperative urologic testing and management (13).…”

Section: Not Usedmentioning

confidence: 99%

Renal Relevant Radiology

Sharfuddin

2014

Clinical Journal of the American Society of Nephrology

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SummaryKidney transplantation can be associated with various complications that vary from vascular complications to urologic disorders to immunologic adverse effects. In evaluating the recipient with graft dysfunction, clinicians can choose among several imaging modalities, including ultrasonography, nuclear medicine studies, computed tomography, and magnetic resonance imaging. This review discusses the evaluation of the kidney transplant recipient using these imaging procedures, emphasizing the clinical diagnostic utility and role of each modality. A kidney biopsy is often required as a gold standard for diagnostic purposes. However, because of the inherent risks of a kidney biopsy, noninvasive imaging in diagnosing causes of graft dysfunction is a highly desired tool used and needed by the transplant community. Because the diagnostic accuracy varies depending on the time course and nature of the transplant-related complication, this review also addresses the advantages and limitations of each modality. The recent advances in kidney transplant imaging techniques and their clinical implications are also discussed.

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“…Immunosuppressive medications, particularly cyclosporine, also increase urine concentration and serum and urine uric acid levels (3,4), each of which might be expected to increase de novo stone formation. However, nephrolithiasis is reportedly rare after renal transplantation (5)(6)(7)(8)(9)(10), presumably due to the combination of careful donor screening, the denervated condition of the allograft kidney which would mask renal colic, and early loss of concentrating ability leading to polyuria (11). This problem has not been studied in a national population of renal transplant recipients.…”

Section: Introductionmentioning

confidence: 99%

Hospitalized Nephrolithiasis after Renal Transplantation in the United States

Abbott

Schenkman²,

Swanson

et al. 2003

American Journal of Transplantation

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The national incidence of and risk factors for hospitalized nephrolithiasis (NEP) in renal transplant (RT) recipients has not been reported. We conducted a historical cohort study of 42 096 RT recipients in the United States Renal Data System between 1 July 1994 and 30 June 1998. The 1-year incidence of NEP (ICD-9 codes 592.x) after RT in 1997 was compared to the rate of NEP in the general population using the National Hospital Discharge Survey. Associations with time to hospitalizations for a primary diagnosis of nephrolithiasis were assessed by Cox Regression. NEP was uncommon after RT (104 cases per 100 000 person years in 1997). However, females, but not males, had a statistically significant increased risk of NEP compared to the general population (rate ratio for females, 2.84, 95% confidence interval, 2.35-3.58). Kidney stones were more common than ureteral stones, and percutaneous procedures were more common than ureteroscopy or extracorporeal shock wave lithotripsy (ESWL). The only risk factor identified for NEP was renal failure due to stone disease (only one case). NEP was uncommon after RT, but was still more common than in the general population. We identified differences in the presentation and management of NEP after RT in comparison to the general population.

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Urological Complications in Pediatric Renal Transplantation

Cited by 47 publications

References 17 publications

Renal transplantation in children with posterior urethral valves

Renal transplantation in children with posterior urethral valves

Renal Relevant Radiology

Hospitalized Nephrolithiasis after Renal Transplantation in the United States

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