Abstract
Ureteral stenosis is one of the most common urological complications following kidney transplantations. It is occurred in 2–10% of patients and poses a significant problem to the patients as it may lead to permanent damage to renal damage. Identification of risk factors is important to prevent the incidence of ureteral stenosis. Thus, we aim to determine the risk factors of ureteral stenosis in the Indonesian population. This is a retrospective analysis of 487 kidney transplant patients performed in Cipto Mangunkusumo Hospital between 2014 and 2018. We collected and compared donor and recipient demography data in recipients who developed ureteral stenosis and recipients who did not develop ureteral stenosis. Ureteral stenosis was defined as the presence of hydronephrosis from ultrasound and increased number of serum creatinine. The overall incidence of ureteral stenosis post-kidney transplantation in our center is 6.6% (32 from 487 patients) from January 2014 until June 2018. We found that older donor and recipient age more frequent in developing ureteral stenosis post-kidney transplantation (p < 0.001). We also found that donors with number of arteries more than 2 (p < 0.001) and prolonged warm ischemic time (p < 0.05) are more frequently to develop ureteral stenosis post-kidney transplantation. There is no association between type II diabetes mellitus and hypertension with ureteral stenosis in this study. Donor age, recipient age, donor number of arteries more than 2, and prolonged warm ischemia time are associated with ureteral stenosis after kidney transplantation.
Highlights
End-stage renal disease (ESRD) is a worldwide public health problem with increasing prevalence each year
Reduced number of graft failures apparently is followed by an increase in posttransplant urological complications [7]. e most common urological complication following kidney transplantation is ureteral stenosis [5], which occurred in 2–10% of patients receiving kidney transplantation [4]
Ureteral ischemia is known as the most common etiology for ureteral stenosis, which accounted for 60–95% of cases of ureteral stenosis. e distal ureter is the most vulnerable part of the ureter to develop ureteral ischemia owing to its anatomical location that is the furthest part of the renal artery [5]
Summary
End-stage renal disease (ESRD) is a worldwide public health problem with increasing prevalence each year. Ureteral stenosis poses significant problems to patients with kidney transplantation as it may lead to permanent damage to the renal allograft [6]. No studies have been conducted in Indonesian population to identify the risk factors of ureteral stenosis after kidney transplantation. Us, we aim to determine the risk factors of allograft ureteral stenosis following kidney transplantation in Indonesian population. We collected the demographic data, intraoperative parameters, and postoperative parameters from both donor and recipient. We found that there were significant differences in donor and recipient age in patients who develop ureteral stenosis following kidney transplantation. E relationship between donor and recipient did not play a significant role in developing ureteral stenosis after kidney transplantation (p 0.68) No difference was found in donor and recipient sex between the two groups (p 0.2 and p 0.85). e relationship between donor and recipient did not play a significant role in developing ureteral stenosis after kidney transplantation (p 0.68)
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