Renal transplant outcome after endoscopic treatment of vesicoureteral reflux using the subureteric injection of calcium hydroxyapatite.
OBJECTIVE
To evaluate the results of end-stage renal failure in transplanted cases due to vesicoureteral reflux after a subureteric injection of calcium hydroxyapatite (Coaptite).


METHODS
Twenty-three patients (39 renal units) with end-stage renal failure secondary to vesicoureteral reflux were included. Reflux was bilateral in 16 cases and unilateral in 7 of the cases. There were 3 degrees of reflux according to the distribution of renal units. They were low-grade reflux (grades 1 and 2; n=10); medium-grade reflux (grade 3; n=23); and high-grade reflux (grades 4 and 5; n=6).


RESULTS
Reflux resolved completely in 17 patients (28 renal units; 71.8%). There was a regression to grade 1 in 3 patients (5 renal units; 12.8%). Twenty-one patients underwent renal transplant; however, 2 of the patients were excluded from the study as it was not possible to monitor them after transplant. Within an approximately 18.6 month follow-up (range, 3-36 months), 1 of the cases had acute, and 3 of the cases had chronic rejection.


CONCLUSIONS
Successful results can be achieved in reflux treatment by an injection of subureteric calcium hydroxyapatite before transplant in patients with end-stage renal failure that developed secondary to vesicoureteral reflux.
Dirim
Ayhan
A
Department of Urology, Baskent University School of Medicine, Ankara, Turkey. drayhan_dirim@yahoo.com
Celik
Huseyin
H
Hasirci
Eray
E
Aygun
Cem
C
Turunc
Tahsin
T
Ozkardes
Hakan
H
Haberal
Mehmet
M
D000293:Adolescent; D000328:Adult; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D017886:Durapatite / Q000008:administration & dosage / Q000627:therapeutic use*; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000188:drug therapy*; D055815:Young Adult
D001672:Biocompatible Materials; D017886:Durapatite