Correlations between pretransplant dialysis duration, bladder capacity, and prevalence of vesicoureteral reflux to the graft.

Abstract

BACKGROUND:

Urinary bladder capacity is reduced in patients undergoing long-term dialysis, which may increase the risk of vesicoureteral reflux (VUR) to a transplanted kidney. This study investigated the correlations between dialysis duration, pretransplant and posttransplant bladder capacity, and prevalence of VUR to the graft.

METHODS:

Voiding cystography was performed in 101 adult renal transplant recipients without neurogenic disorders immediately before and 1 year after transplantation to evaluate bladder capacity and VUR. Nonstented extravesical antireflux ureteroneocystostomy was performed in all patients.

RESULTS:

The median dialysis duration and pretransplant bladder capacity were 32 months (range 1-426 months) and 120 mL (range 15-450 mL), and 21 patients (20.8%) underwent dialysis for more than 120 months, and 30 patients (29.7%) had a pretransplant bladder capacity of less than 80 mL. Dialysis duration was correlated with pretransplant bladder capacity (R=0.466, P<0.001). Bladder capacity expanded more than 6-fold from pretransplantation to posttransplantation, and all recipients had a bladder capacity greater than 150 mL at 1 year posttransplantation. Thirty patients had VUR to the graft. Dialysis duration longer than 60 months (P=0.021) and pretransplant bladder capacity of less than 130 mL (P=0.024) were associated with VUR. VUR was associated with lower graft function.

CONCLUSIONS:

Although bladder capacity decreased because of long-term dialysis, it exceeded 150 mL at 1 year posttransplantation. A small bladder can be used in renal transplantation, but it may increase the risk of VUR.

• Authors: Takamitsu Inoue, Shigeru Satoh, Mitsuru Saito, Kazuyuki Numakura, Hiroshi Tsuruta, Takashi Obara, Shintaro Narita, Yohei Horikawa, Norihiko Tsuchiya, Tomonori Habuchi
• Journal: Transplantation (Transplantation) Vol. 92 Issue 3 Pg. 311-5 (Aug 15 2011) ISSN: 1534-6080 [Electronic] United States
• PMID: 21659949 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Cystostomy (methods)
• Female
• Graft Survival (physiology)
• Humans
• Kidney Transplantation
• Male
• Middle Aged
• Organ Size
• Postoperative Complications (epidemiology)
• Preoperative Care (statistics & numerical data)
• Prevalence
• Renal Dialysis (statistics & numerical data)
• Risk Factors
• Time Factors
• Urinary Bladder (anatomy & histology, physiology)
• Vesico-Ureteral Reflux (epidemiology)
• Young Adult