Abstract
Background: Renal transplantation (RTX) is thought to have high survival rates. However, patients with long-term dialysis have decreased bladder function due to disuse. High urine production after RTX surgery might cause patients to have urinary symptoms, thus decreasing their quality of life. The aim of this study was to evaluate voiding characteristics of patients after RTX surgery. Methods: All patients were diagnosed with chronic kidney disease (CKD) and underwent kidney transplantation from a living donor. Anthropometric parameters, physical examinations, cause of CKD, daily urine production, types and duration of dialysis, and basic laboratory examination were collected before transplant surgery. Post-operative examinations included laboratory examination, international prostate symptom score (IPSS; for male patients only), overactive bladder symptom score (OABSS), uroflowmetry, and post void residue (PVR). Results: 71 patients were evaluated with a mean age of 46 ± 17.9 years, with male and female ratio of 52:19. Significant negative correlation was seen between duration of dialysis and daily urine production (r: -0.68, p<0.01). Majority of patients had a maximum flow rate of >15 cc/s (70.4 %) with average flow of 22 ± 9.8 cc/s. The majority of patients had PVR <100 cc (91.5%) with median PVR of 33.5 cc (range, 2.3 – 142 cc). IPSS result showed that frequency [2 (0 – 5)] and nocturia [2 (0 – 5)] are the main problem in these patients (n = 52). OABSS questionnaire also showed that frequency (OABSS 1; score 1 [1-2]) and nocturia (OABSS 2; score 2 [0-3]) was the main symptoms reported by patients. Conclusion: After RTX, the majority of patients experienced urinary frequency and nocturia problems due to various causes such as increased daytime and nighttime urine production, urinary tract infection, changes in bladder capacity (both small and large), and a decrease in bladder compliance.
Highlights
Chronic kidney disease (CKD) is a health burden affecting the global population, which has a high economic cost to health care, increases the risk of cardiovascular morbidity and decreases overall quality of life (QoL)[1]
Dialysis was thought to be the best treatment for patients with chronic kidney disease (CKD), nowadays transplantation is a more attractive treatment due to its higher survival rates, QoL, cost effectiveness, and better clinical results[6,7]
Patients with CKD who experienced prolonged oliguria and or anuria may develop bladder function complications and high intravesical pressure, known as neurogenic bladder, which may lead to renal impairment[8]
Summary
Chronic kidney disease (CKD) is a health burden affecting the global population, which has a high economic cost to health care, increases the risk of cardiovascular morbidity and decreases overall quality of life (QoL)[1]. The global prevalence of the five stages of CKD is between 11 – 13% with the majority of patients being stage 3, while stages 3–5 (end stage renal disease) is 10.6% (9.2 – 12.2%)[1]. Dialysis was thought to be the best treatment for patients with CKD, nowadays transplantation is a more attractive treatment due to its higher survival rates, QoL, cost effectiveness, and better clinical results[6,7]. High urine production after RTX surgery might cause patients to have urinary symptoms, decreasing their quality of life. Anthropometric parameters, physical examinations, cause of CKD, daily urine production, types and duration of dialysis, and basic laboratory examination were collected before transplant surgery. Conclusion: After RTX, the majority of patients experienced urinary frequency and nocturia problems due to various causes such as Invited Reviewers version 1
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