Microhematuria after renal transplantation in children

Butani, Lavjay; Berg, Gerre; Makker, Sudesh P

doi:10.1007/s00467-002-1000-5

Cited by 4 publications

(5 citation statements)

References 15 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%

“…In 2002, Butani et al evaluated 21 paediatric Kidney transplant recipients and seven (33%) had persistent microscopic haematuria. The possible causes explained for the microscopic haematuria included intermittent bladder catheterization, recurrent IgA nephropathy, cytomegalovirus (CMV) nephritis and unexplained reasons [2]. A more extensive cross-sectional study enrolled 640 kidney transplant recipients for dipstick urinalysis.…”

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%

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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“…Routine testing for dipstick haematuria in renal transplant patients is commonly performed but data regarding the frequency of this complication are lacking. In a small, recently published series of paediatric recipients, microhaematuria was found in one‐third of patients (1). In our study of adult renal transplant patients, the prevalence of persistent dipstick haematuria was 13.3%.…”

Section: Discussionmentioning

confidence: 99%

“…Despite a perception that testing for dipstick haematuria is widely practised, there are no reports of the frequency or causes of this finding in adult renal transplant populations. The only published series is one of paediatric transplant recipients in which seven of 21 patients attending a transplant follow‐up clinic had persistent dipstick‐positive haematuria (1).…”

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confidence: 99%

Persistent dipstick haematuria following renal transplantation

McDonald¹,

McMillan²,

Rodger³

et al. 2004

Clinical Transplantation

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Despite widespread testing for dipstick haematuria following renal transplantation, there are no published series describing the prevalence and possible causes of this complication in an adult population. A cross-sectional study of 640 renal transplant recipients under review at our follow-up clinic was performed. Persistent haematuria was defined as a minimum of 1+ of blood on urinalysis stick testing detected at not fewer than 75% of clinic visits since its onset, or since the start of routine testing, present over a period of at least 4 weeks. The prevalence of persistent dipstick haematuria was 13.3%. Median serum creatinine was higher in patients with persistent haematuria but age, gender and length of time since transplantation were not significantly different. Potential explanations for persistent haematuria in 21 of 85 affected patients were chronic infection, ureteric stent without chronic infection, regular or intermittent self-catheterization, persistent menstrual bleeding, anticoagulant therapy, graft calculus, and allograft renal cell carcinoma. Recurrent or de novo glomerular disease was confirmed by graft biopsy in 10 of 85 patients. Among the 41 recipients whose original cause of renal failure was IgA nephropathy (IgAN), the prevalence of persistent haematuria was 31.7% compared with 12% in the remaining patients (relative risk 2.6, 95% CI: 1.6-4.3). Persistent haematuria in IgAN patients was not associated with gender, age or time since transplantation. After 29 months of follow-up, 20% of patients with haematuria had progressed to graft failure or death compared with 11.6% of the unaffected group (p = 0.029). However, despite the association with earlier graft failure, haematuria did not predict this endpoint independently of renal function.

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“…The presence of segmental sclerosis in hypertrophied glomeruli is related to proteinuria in patients with posttransplant IgAN [10]. However, development of microscopic hematuria is not a characteristic feature of recurrent IgAN [13,14]. Mesangial IgA deposition on the donor kidney is associated with development of proteinuria, microscopic hematuria, and delayed graft function in kidney recipients [15,16].…”

Section: Introductionmentioning

confidence: 99%