title: Value of routine voiding cystourethrography after renal transplantation.
abstract: The impact of vesicoureteral reflux (VUR) on renal allograft outcomes is debatable, with small cohort studies reporting controversial results. The objective of this retrospective study was to evaluate long-term clinical effects of early VUR in a large cohort of kidney transplant patients. Posttransplantation voiding cystourethrography was used to evaluate 646 consecutive kidney transplant recipients before discharge. The study endpoints included VUR grade, death-censored graft or patient survival, renal function, proteinuria and occurrence of urinary tract infections (UTIs). Of the 646 recipients, 263 (40.7%) were diagnosed with VUR. VUR grade II was most common (19.8%), followed by grades III (10.2%), I (7.9%) and IV (2.8%). VUR was less common in transplantations performed by experienced compared to inexperienced surgeons (36% vs. 48%; p = 0.004). VUR did not affect death-censored graft or patient survival and was not associated with proteinuria or occurrence of UTIs. Patients with VUR had a lower eGFR at 1 year after transplantation than did patients without VUR (60 vs. 52 mL/min/1.73 m(2) ; p = 0.02), although this difference was not observed at 3 and 5 years after transplantation. We conclude that early VUR, a common finding among renal transplant patients, may not have a meaningful impact on long-term transplant outcomes.
authors.affiliation: Department of Urology, Medical University Vienna, Austria. markus.margreiter@meduniwien.ac.at
authors.forename: M
authors.initials: M
authors.lastname: Margreiter
authors.forename: G P
authors.initials: GP
authors.lastname: Györi
authors.forename: G A
authors.initials: GA
authors.lastname: Böhmig
authors.forename: S
authors.initials: S
authors.lastname: Trubel
authors.forename: F
authors.initials: F
authors.lastname: Mühlbacher
authors.forename: R
authors.initials: R
authors.lastname: Steininger
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000209:etiology / Q000517:prevention & control; D014552:Urinary Tract Infections / Q000209:etiology / Q000517:prevention & control; D014554:Urination; D014567:Urography / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000150:complications*