title: Residual urinary volume is a risk factor for primary nonfunction in kidney transplantation.
abstract: Primary nonfunction is a severe complication after kidney transplantation. Residual renal function could be a risk factor for this complication in the current era of kidney transplantation from extended criteria donors (ECD). This is a single-center case-control study. Between 2000 and 2012, 1112 patients received a kidney transplant from a deceased donor. We identified 56 cases of early graft loss (kidney that never recover renal function and/or graft thrombosis <48 h after kidney transplantation). As controls we used patients receiving the contralateral kidney. Donor age was 55 ± 17 years with 57% fulfilling ECD criteria. Among the 56 cases, 14 were due to vascular rejection and 42 to primary nonfunction. Risk factors for early graft loss due to vascular rejection were previous transplant, time on dialysis, and HLA sensitization. Risk factors for primary nonfunction were first transplant, short period on dialysis, mainly peritoneal dialysis, and a residual urinary volume ≥500 ml/24 h. Conditional logistic regression analysis showed that residual urinary volume (OR = 20.01) rather than the dialysis modality was a major risk factor for primary nonfunction. In conclusion, residual urinary volume seems to be a risk factor for primary nonfunction in the current era of kidney transplantation.
authors.affiliation: Nephrology Department, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Cruzado
authors.affiliation: Nephrology Department, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Manonelles
authors.affiliation: Urology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
authors.forename: Helena
authors.initials: H
authors.lastname: Vila
authors.affiliation: Nephrology Department, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Melilli
authors.affiliation: Nephrology Department, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain.
authors.forename: Neus
authors.initials: N
authors.lastname: Sala
authors.affiliation: Nephrology Department, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain.
authors.forename: Oriol
authors.initials: O
authors.lastname: Bestard
authors.affiliation: Nephrology Department, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Torras
authors.affiliation: Statistical Advisory Service, Bellvitge Biomedical Institute-IDIBELL, Faculty of Medicine and Health Sciences, University Rovira i Virgili, L'Hospitalet de Llobregat, Spain.
authors.forename: Cristian
authors.initials: C
authors.lastname: Tebé
authors.affiliation: Urology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Riera
authors.affiliation: Nephrology Department, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Grinyó
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007511:Ischemia; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis; D055031:Primary Graft Dysfunction / Q000175:diagnosis; D012044:Regression Analysis; D051437:Renal Insufficiency / Q000601:surgery* / Q000652:urine*; D012107:Research Design; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis; D014019:Tissue Donors; D014556:Urine
chemical_list: D006680:HLA Antigens
keywords: early graft failure; renal transplantation; residual renal function