Long-term clinical impact of vesicoureteral reflux in kidney transplantation.
BACKGROUND
It is unclear whether the presence of vesicoureteral reflux (VUR) after renal transplantation compromises long-term graft function. The aim of this study in renal allograft recipients with a history of late recurrent urinary tract infections (UTI) was to determine whether the presence of VUR conferred an increased risk of long-term graft dysfunction.


METHODS
We included 37 renal allograft recipients, who were at least 2 years after transplantation and had a history of at least 1 recurrent UTI per year underwent voiding cystourethrograms (VCUG). The presence and severity of VUR were graded with severity scores ranging from G1 to G5.


RESULTS
Of the 37 patients, 15 (41%) showed low grades of reflux (G1-3) on VCUG. Patient and graft survivals were not significantly different in the VUR group (n = 15) compared with the no VUR group (n = 22) at 1, 3, or 5 years. Renal function assessment by means of serum creatinine (Cr) concentration also demonstrated similar results in both groups at 1, 3, and 5 years: 5 y mean Cr: VUR 1.5 +/- 0.6 mg/dL versus no VUR 1.8 +/- 1.1 mg/dL (P = NS). No difference was also observed in the 2 groups in the number of UTI episodes for each patient per year.


CONCLUSIONS
In patients with late UTIs, the presence of low-grade VUR did not affect long-term graft function. There was no indication for a operative repair of low-grade VUR.
Favi
E
E
Department of Surgery, Organ Transplantation, Renal Program, Catholic University, Policlinico Agostino Gemelli, Rome, Italy.
Spagnoletti
G
G
Valentini
A L
AL
Tondolo
V
V
Nanni
G
G
Citterio
F
F
Castagneto
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D003404:Creatinine / Q000097:blood; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D066027:Transplant Recipients; D014718:Vesico-Ureteral Reflux / Q000150:complications*; D055815:Young Adult
D003404:Creatinine