Atrophic bladder in long‐term dialysis patients increases the risk for urological complications after kidney transplantation

Abstract

Bladder atrophy in renal transplant recipients after long-term dialysis therapy is associated with a higher risk of urological complications.

Urologic complications in renal transplants

“…Factors that have been associated with higher rates of overall urologic complications include male gender, delayed graft function, donor age over 65, abnormal pre-transplant VCUG, repeat transplant, obesity, multiple donor arteries, and excessive removal of fat from the donor ureter (4,12,(14)(15)(16). Atrophic bladders have also been associated with a higher risk of urological complications (13). In addition, post-transplant diagnosis of benign prostatic hypertrophy has been reported to be associated with more post-transplant urinary outflow obstructive complications (17).…”

“…The incidence of urologic renal transplant complications varies widely in the literature. The overall incidence ranges from 3.4-11.2% (4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Complications such as ureteral stricture, urine leak, symptomatic vesicoureteral reflux (VUR), urolithiasis, bladder outlet obstruction, and urinary tract obstruction from lymphocele are among the most common (4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

Increasing bladder capacity and vesicoureteral reflux in pediatric kidney transplant patients

“…[17][18][19] Other adult studies reported that pretransplant atrophic bladder did not impair graft function [20][21][22] and achieved good capacity after KTx. 14,17,20,21 Bladder capacity gradually decreased as the pretransplant duration of dialysis increased. 17 However, in the present study, the average duration of dialysis was 42 AE 27 months, which was shorter than in adult studies.…”

“…In previous studies, pretransplant atrophic bladder, due, for example, to long‐term dialysis, was found to cause urological complications and graft dysfunction 17–19 . Other adult studies reported that pretransplant atrophic bladder did not impair graft function 20–22 and achieved good capacity after KTx 14,17,20,21 . Bladder capacity gradually decreased as the pretransplant duration of dialysis increased 17 .…”

“…14,17,20,21 Bladder capacity gradually decreased as the pretransplant duration of dialysis increased. 17 However, in the present study, the average duration of dialysis was 42 AE 27 months, which was shorter than in adult studies. Bladder capacity was small compared with EBC regardless of the duration of dialysis, and average various pediatric factors, such as age and physique, rather than duration of dialysis, might be related to bladder capacity.…”