Bladder dysfunction and end stage renal disease.
OBJECTIVE
Evaluation of lower urinary tract function in patients with end-stage renal disease and lower urinary tract symptoms. Patients were screened before entering a renal transplantation program.


METHODS
A diagnostic work-up including urodynamics was performed on 52 patients (14 women, 38 men) suffering from renal failure due to chronic glomerulonephritis (n = 25), diabetic nephropathy (n = 15), chronic pyelonephritis/stone disease (n = 9) and polycystic kidney disease (n = 3).


RESULTS
Abnormalities in lower urinary tract function of different degrees were found in 40 patients (77%). Major problems are bladder hypersensitivity (n = 31%), poor bladder compliance (38%), detrusor instability (25%) and detrusor-sphincter dyssynergia (33%).


CONCLUSIONS
There is a high incidence of bladder dysfunction of different degrees in patients with renal failure. The clinical significance, especially in the long term, needs to be evaluated. However, a urodynamic assessment before renal transplantation is recommended in all patients reporting symptoms of dysfunctional voiding and/or bladder storage problems in order to avoid allograft dysfunction due to chronic bladder dysfunction and related complications. Depending on the degree of bladder dysfunction an urodynamic follow-up after transplantation is necessary. If there are no symptoms and no history of lower urinary tract dysfunction an urodynamic assessment is not necessary.
Zermann
Dirk-Henrik
DH
Department of Urology, University Hospital, Friedrich-Schiller-University Jena, Germany. dh.zermann@med.uni-jena.de
Löffler
Uwe
U
Reichelt
Olaf
O
Wunderlich
Heiko
H
Wilhelm
Steffen
S
Schubert
Jörg
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D001745:Urinary Bladder Diseases / Q000150:complications* / Q000175:diagnosis