title: Debilitating lower urinary tract symptoms in the post-renal transplant population can be predicted pretransplantation.
abstract: BACKGROUND
  Overactive bladder and benign prostatic hyperplasia commonly cause lower urinary tract symptoms (LUTS) in the renal transplant (RTx) population. These LUTS may be masked by low urine output and may pose risk to renal allografts after RTx. Our purpose was to determine the frequency and severity of LUTS in RTx patients and to determine if patients at highest risk for LUTS could be predicted by validated questionnaires or other pre-RTx characteristics.
  
  
  METHODS
  All patients who underwent RTx between 2005 and 2010 were asked to complete the validated Overactive Bladder Questionnaire based on patient symptoms before RTx and at 6 and 12 months after RTx. Male patients also completed the International Prostate Symptom Score survey. Patient, donor, and RTx characteristics and outcome data were collected.
  
  
  RESULTS
  Of 466 RTx recipients, 23.8% responded and 89 patients were eligible for participation in the study. LUTS were common both before and after RTx as measured by the Overactive Bladder Questionnaire and International Prostate Symptom Score. Pre-RTx survey scores were predictive of moderate to severe post-RTx LUTS (relative risk, 4.1-18.0; P≤0.05). Low urine output of less than 250 mL per day was also predictive of moderate to severe post-RTx LUTS (relative risk, 2.9-5.9; P<0.02).
  
  
  CONCLUSIONS
  Validated questionnaires and low urine output before transplantation may be used to identify patients at highest risk for LUTS after RTx. Identification of at risk patients would allow earlier initiation of treatment strategies to improve patient quality of life.
authors.affiliation: Department of Surgery, Division of Urology, Western University, London, Ontario, Canada.
authors.forename: Marie
authors.initials: M
authors.lastname: Dion
authors.forename: Octav
authors.initials: O
authors.lastname: Cristea
authors.forename: Sarah
authors.initials: S
authors.lastname: Langford
authors.forename: Patrick P W
authors.initials: PP
authors.lastname: Luke
authors.forename: Alp
authors.initials: A
authors.lastname: Sener
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000453:epidemiology; D011788:Quality of Life; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000453:epidemiology; D014563:Urodynamics; D055815:Young Adult