title: Does daily urine output really matter in renal transplantation?
abstract: BACKGROUND
  Our objective was to clarify the clinical outcome of renal transplantation based on residual daily urine output (RDUO).
  
  
  METHODS
  We retrospectively analyzed a prospective database of 276 patients who underwent renal transplantation (Tx) between January 2008 and December 2012. Patients had pre-transplantation daily urine output measurement of 24-h proteinuria and were clinically re-evaluated the day before transplantation. We included patients with no daily urine output and those with residual daily urine output. Real bladder capacity was not measured. We excluded patients with a history of lower urinary tract malformation, those treated by trans-ileal conduit or enterocystoplasty, and those with early graft thrombosis or graft primary non-function.
  
  
  RESULTS
  Sex ratio, age at Tx, pre-Tx MHC antibodies levels, donor age, and cold ischemia duration were not significantly different between the 2 groups. Dialysis duration was longer in group I (p<0.001). The dialysis duration was correlated with the volume of residual urine output (r=0.12, p<0.0001). We found 14 (19.4%) urological complications in Group I (11 urinary leaks and 3 urethral stenosis) and 13 (6.4%) in Group II (5 urinary leaks and 8 stenosis). This difference was significant (p=0.0013 and relative risk [RR]=2.2). Absence of residual daily urine output was a risk factor of post-transplantation urinary leak (p<0.0001: RR=2.95). At 3 years, graft survival was 74.7% and 94.6%, respectively, in Group I and II (p=0.003).
  
  
  CONCLUSIONS
  The absence of residual daily urine output seems to be a major risk factor for urological complications. Taking into account recipient residual daily urine output should modify surgical strategy during renal transplantation.
authors.affiliation: Department of Urology and Transplantation, CHU Cote de Nacre, Caen, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Tillou
authors.affiliation: Department of Urology and Transplantation, CHU Cote de Nacre, Caen, France.
authors.forename: Adrien
authors.initials: A
authors.lastname: Lee-Bion
authors.affiliation: Department of Nephrology, CHU Cote de Nacre, Caen, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Hurault de Ligny
authors.affiliation: Department of Urology and Transplantation, HU Cote de Nacre, Caen, France.
authors.forename: Clément
authors.initials: C
authors.lastname: Orczyk
authors.affiliation: Department of Urology and Transplantation, CHU Cote de Nacre, Caen, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Le Gal
authors.affiliation: Department of Urology and Transplantation, CHU Cote de Nacre, Caen, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Desmonts
authors.affiliation: Department of Urology and Transplantation, CHU Cote de Nacre, Caen, France.
authors.forename: Henri
authors.initials: H
authors.lastname: Bensadoun
authors.affiliation: Department of Urology and Transplantation, CHU Cote de Nacre, Caen, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Doerfler
mesh_terms: D000328:Adult; D000368:Aged; D016208:Databases, Factual; D005260:Female; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D001743:Urinary Bladder / Q000503:physiopathology*