Endoscopic subureteral polydimethylsiloxane injection and prevention of recurrent acute graft pyelonephritis.
OBJECTIVE
Vesicoureteral reflux (VUR) is an important factor in recurrent acute graft pyelonephritis (AGPN). In this study, we evaluated the effect of subureteral polydimethylsiloxane (PDS) injection on recurrent AGPN in renal transplant recipients with VUR.


METHODS
64 renal transplant recipients with recurrent AGPN were included, 31 (48%) of whom had VUR. Of the patients with VUR, 19 (61%) were treated with PDS and the others were managed with antibiotics. The effect of PDS treatment on recurrent AGPN was evaluated in terms of the overall success rate, the success rate according to VUR grade, and the number of PDS treatments.


RESULTS
The overall success rate of PDS injection was 63%, and the number of AGPN episodes was significantly reduced after injection compared with the number before injection (0.21 vs. 1.34 times/person-year, respectively, p < 0.05). The success rate of PDS treatment differed with the VUR grade (50% in grade 1, 33% in grade 2, 75% in grade 3, and 67% in grade 4). The success rate in the first trial was 67% and in the second it was 50%.


CONCLUSIONS
PDS injection is an effective treatment for recurrent AGPN in renal allograft recipients with VUR.
Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
Joon Chang
JC
Song
Hyeon Seok
HS
Hwang
Hye Eun
HE
Yoon
Jun Chul
JC
Kim
Bum Soon
BS
Choi
Yong Soo
YS
Kim
Chul Woo
CW
Yang
D000208:Acute Disease; D004129:Dimethylpolysiloxanes / Q000008:administration & dosage*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011704:Pyelonephritis / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome; D014513:Ureter / Q000187:drug effects; D018666:Ureteroscopy / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control
D004129:Dimethylpolysiloxanes; C013830:baysilon