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2015, Number 2

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Rev Mex Traspl 2015; 4 (2)

Kidney transplantation in patients with anuria

Martínez-Mier G, García-Esquina JL, Lara-Gutiérrez J, Alvarado-Arenas R, Méndez-López MT, Budar-Fernández LF, Soto-Miranda E, Hernández-Maldonado E, González-Velázquez F, Uscanga-Montesano A, Trujillo-Martínez MF, Ávila-y Falfán D

Language: Spanish
References: 19
Page: 66-73
PDF size: 255.96 Kb.


ABSTRACT

Background: When kidney transplantation is performed in patients with anuria, implantation of the ureter into the bladder can be challenging and can have possible long-term consequences. Material and methods:We examined the outcomes of kidney transplant receptors with anuria (residual urine output ‹ 100 mL/day) (n = 30) compared to a group without anuria (n = 81) during a 10-year period. Results: Anuric subjects had longer time on dialysis than the non-anuric control group (p = 0.006). The urological complication rate in anuric patients (13.3%) was similar to the control group (9.9%) (p = 0.4). Anuric subjects had a significantly higher minor (41.4%) and complicated (34.5%) urinary tract infection rate than non-anuric ones (18.6% & 28.6 respectively) (p = 0.01). There were no statistically significant differences between groups in delayed graft function and creatinine clearance at one, three and five years. Ten-year graft survival was 75% in anuric patients and 72% in non-anuric ones (p = ns). Ten-year patient survival was similar between groups. Conclusions: Anuric sibjects should be closely monitored and followed for the prevention and treatment of urinary tract infections.


REFERENCES

  1. Cabello BR, Quicios DC, López ML, Simón RC, Charry GP, González EC. The candidate for renal transplantation work up: medical, urological and oncological evaluation. Arch Esp Urol. 2011; 64 (5): 441-460.

  2. Power RE, Hickey DP, Little DM. Urological evaluation prior to renal transplantation. Transplant Proc. 2004; 36 (10): 2962-2967.

  3. Martin X, Aboutaieb R, Soliman S, el Essawy A, Dawahra M, Lefrancois N. The use of long-term defunctionalized bladder in renal transplantation: is it safe? Eur Urol. 1999; 36 (5): 450-453.

  4. Ushigome H, Sakai K, Suzuki T, Nobori S, Yoshizawa A, Akioka K et al. Kidney transplantation for patients on long-term hemodialysis. Transplant Proc. 2008; 40 (7): 2297-2298.

  5. Chen JL, Lee MC, Kuo HC. Reduction of cystometric bladder capacity and bladder compliance with time in patients with end-stage renal disease. J Formos Med Assoc. 2012; 111 (4): 209-213.

  6. Serrano DP, Flechner SM, Modlin CS, Wyner LM, Novick AC. Transplantation into the long-term defunctionalized bladder. J Urol. 1996; 156 (3): 885-888.

  7. Wu YJ, Veale JL, Gritsch HA. Urological complications of renal transplant in patients with prolonged anuria. Transplantation. 2008; 86: 1196-1198.

  8. Chun JM, Jung JB, Park GS, Choi CH, Kwon JW, Lee SK et al. Renal transplantation with a small bladder. Transp Proc. 2008; 40: 2333-2335.

  9. Martínez-Mier G. Renal transplantation. In: Hoballah JJ, Scott-Conner CE, eds. Operative dictations in general and vascular surgery. New York: Springer-Verlag; 2003. pp. 368-371.

  10. Martínez-Mier G, Jiménez-López LA, Valencia-Mercado D, Salas-Díaz FA, González-Medina MF. Urological complications following kidney transplantation using Lich-Gregoir technique: A 4-year experience in Mexico. Cir Ciruj. 2009; 77: 111-114.

  11. Levey AS, Bosch JP, Lewis JB et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of diet in renal disease study group. Ann Intern Med. 1999; 130: 461-470.

  12. Mangus RS, Haag BW. Stented versus non-stented extravesical ureteroneocystostomy in renal transplantation: a metaanalysis. Am J Transp. 2004; 4: 1889-1896.

  13. Slagt IK, Ijzermans JN, Visser LJ, Weimar W, Roodnat JI. Independent risk factors for urological complications after deceased donor kidney transplantation. PLOS One. 2014; 9: e91211.

  14. Streeter EH, Little DM, Cranston DW, Morris PJ. The urological complications of renal transplantation: a series of 1535 patients. BJU Int. 2002; 90: 627-634.

  15. Dinckan A, Tekin A, Turkyilmaz S, Kocak H, Gurkan A, Erdogan O et al. Early and late urological complications corrected surgically following renal transplantation. Transp Int. 2007; 20: 702-707.

  16. Sorto R, Irizar SS, Delgadillo G, Alberu J, Correa-Rotter R, Morales-Buenrostro LE. Risk factors for urinary tract infections during the first year after kidney transplantation. Transp Proceed. 2010; 42: 280-281.

  17. Säemann M, Hörl WH. Urinary tract infection in renal transplant recipients. Eur J Clin Invest. 2008; 38 (S2): 58-65.

  18. Chuang P, Parikh CR, Langone A. Urinary tract infections after renal transplantation: a retrospective review at two transplant centers. Clin Transp. 2005; 19: 230-235.

  19. Ariza-Heredia EJ, Beam EN, Lesnick TG, Cosio FG, Kremers WK, Razonable RR. Impact of urinary tract infection of allograft function after kidney transplantation. Clin Transp. 2014; 28: 683-690.




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