Introduction:
Structural urological abnormalities leading to a dysfunctional lower urinary tract and subsequent end-stage renal disease may affect approximately 15% of the adult population and 20% to 30% of the pediatric population. The literature on renal transplant outcomes in patients with abnormal lower urinary tract (LUT) remains inconclusive. This study aims to assess graft outcomes and the incidence of urinary tract infection symptoms in patients with optimized abnormal LUT, in comparison to those with normal LUT.
Methods:
In a single-centre, retrospective matched cohort study conducted between 2016 and 2023, 30 patients with optimized abnormal lower urinary tract (LUT) were compared to 30 sex- and age-matched patients with normal LUT who underwent renal transplantation during the same period. The primary outcome assessed was graft survival, with secondary outcomes including overall survival and complication rates.
Results:
The mean age of the cohort was 36 years, with 94% of the participants being male in each group. The median follow-up duration was 36 months in both groups. Posterior urethral valve was the most common cause of abnormal LUT. ≥2 episodes of UTI was significantly higher in patients with abnormal LUT compared to those with normal LUT (23.3% vs. 3.3%; p < 0.05).
Graft survival was comparable between the groups: 93.3% and 86.7% at one and three years for abnormal LUT, and 96.7% and 87.5% for normal LUT.
Conclusions:
Despite higher incidence of urinary tract infections in patients with abnormal LUT, the graft survival was not significantly different in patients with abnormal and normal bladder. Therefore it is safe to transplant into abnormal LUT once they have been assessed and managed appropriately.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.