Dysfunction of lower urinary tract in renal transplant children with nephrologic disease

• Published in: Urology (Ridgewood, N.J.) N.J.), 2006-05, Vol.67 (5), p.1060-1065
• Main Authors: Van der Weide, Marian J.A., Cornelissen, Elisabeth A.M., Van Achterberg, Theo, Smits, Jeroen P.J.M., Feitz, Wouter F.J.
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Creatinine - blood; Female; Graft Survival - physiology; Humans; Kidney Diseases - surgery; Kidney Diseases - therapy; Kidney Transplantation - adverse effects; Male; Nephrectomy; Renal Replacement Therapy; Retrospective Studies; Surveys and Questionnaires; Urinary Bladder Diseases - etiology; Urinary Bladder Diseases - physiopathology; Urinary Tract Infections - etiology; Urination Disorders - etiology; Urination Disorders - physiopathology; Urine; Urodynamics
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2005.11.065

To investigate the relationship between dysfunction of the lower urinary tract after renal transplantation and renal transplant function in children with an underlying nephrologic disease. The research group consisted of 21 renal transplant children (12 girls and 9 boys, mean age 13.5 years, range 6 to 18) with an underlying nephrologic disease. To indicate renal transplant function, the calculated creatinine clearance rate (Ccr) according to Schwartz was used. The Ccr was measured at two points, 2 months after transplantation and at the moment of study. The average graft age was 34 months (range 5 to 85). The data on dysfunction of the lower urinary tract were gathered using a written questionnaire, frequency volume chart, free uroflowmetry, transabdominal ultrasonography, and medical records. To determine the relationship between the symptoms of dysfunction of the lower urinary tract and Ccr at the moment of study, we computed bivariate correlations and performed multivariate regression analyses in which the associations were studied while controlling for the Ccr 2 months after transplantation and graft age. A sensation of incomplete emptying ( P = 0.03), postvoid residual urine volume ( P = 0.06), and urinary tract infection ( P = 0.004) correlated negatively with the Ccr at the moment of study. These effects remained present ( P = 0.07, P = 0.03, and P = 0.003, respectively) while controlling for graft age and the Ccr at 2 months after transplantation in the regression analysis. The results of our study have shown that a postvoid residual urine volume and urinary tract infections after renal transplantation may result in renal transplant deterioration in children with an underlying nephrologic disease.