CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2020; 29(01): 032-038
DOI: 10.1055/s-0039-1696698
Original Article | Artículo Original
Renal Transplant/Trasplante Renal
Sociedad Colombiana de Urología. Publicado por Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Capacidad Vesical como Pronóstico de Trasplante Renal

Bladder Capacity as a Renal Transplant Prognosis
William Ricardo Fajardo Cediel
1   Grupo Trasplante Fundación Clínica Shaio, Bogotá D.C., Colombia
,
Karen Viviana Flórez Barbosa
1   Grupo Trasplante Fundación Clínica Shaio, Bogotá D.C., Colombia
,
Jenny Catherin García Cuevas
2   Universidad de La Sabana, Chía Cundinamarca, Colombia
,
María Paula Rodríguez
2   Universidad de La Sabana, Chía Cundinamarca, Colombia
,
Mónica María Zúñiga Castrillón
3   Medicina Crítica y Cuidado Intensivo, Universidad de La Sabana, Chía Cundinamarca, Colombia
,
Carolina Andrea Duarte Gonzalez
4   Pontificia Universidad Javeriana, Bogotá D.C., Colombia
› Author Affiliations
Further Information

Publication History

29 November 2018

19 July 2019

Publication Date:
16 December 2019 (online)

Resumen

Introducción La capacidad vesical pre trasplante renal, ha demostrado tener un impacto significativo en el pronóstico, la calidad de vida y complicaciones urológicas en los pacientes.

Métodos Estimar la correlación de Pearson que existe entre la capacidad vesical pre- trasplante (CVPRE) comparado con el tiempo de duración de Terapia de reemplazo renal (TRR); como factor pronóstico.

Método Se realizó una base de datos de pacientes con Trasplante Renal realizados por un Grupo Trasplante, de una sola institución, en los últimos 7 años, desde el 2010 hasta el año 2018. Se tomaron datos del estudio pre trasplante por parte del servicio de Urología y controles mensuales pos trasplante, hasta la fecha. Se tomaron en cuenta datos como: Tiempo de diagnóstico de ERC estadio final, tiempo y tipo de terapia de reemplazo renal, capacidad vesical y función renal pre-trasplante versus función renal y capacidad vesical pos-trasplante y complicaciones urológicas pos-trasplante. Con esos datos, se realizó el cruce de variables, utilizando el Coeficiente de correlación de Pearson, expresando resultados con valores entre 1, para mostrar correlación y significancia estadística en la práctica clínica.

Resultados Entre los años 2010 hasta mayo de 2018, se llevaron a cabo 203 Trasplantes renales, se tabularon 114 pacientes cuyos datos se encontraban completos. La Correlación Pearson fue de: −0,3 entre tiempo de TRR y CVPRE; −0,14 entre CVPRE y creatinina pos TR; 0,09 entre CVPRE y RVU; de 0,14 entre CVPRE e IVU; esas 2 últimas, complicaciones urológicas pos-trasplante renal.

Conclusiones Existe correlación inversa entre el tiempo de TRR y Capacidad vesical pre- trasplante, lo cual influye en el pronóstico del paciente trasplantado renal, en términos de función renal pos-trasplante y complicaciones urológicas dadas por RVU e IVU.

Abstract

Introduction The bladder capacity has demonstrated to have an important impact in prognosis, quality of life and urological complications in patients.

Objective Estimate the Pearson correlation that exists between pre-transplant bladder capacity compared to the duration of renal replacement therapy (RRT); as a prognosis factor.

Methods A database of Kidney Transplantation patients performed by a Transplant Group, from a single institution, during the last 7 years, from 2010 to 2018, was made. Data from the pretransplant study carried out by the Urology Service and from the post-transplant monthly controls, to date were also analyzed. Data such as: Time of CKD final stage diagnosis, time and type of renal replacement therapy, bladder capacity and pretransplant renal function versus post-transplant renal function and bladder capacity and post-transplant urological complications, were also taken into consideration. With these data, a variable crossing was carried out, using the Pearson Correlation Coefficient, expressing results with values ranging between −1 and 1, to show correlation and statistical significance in clinical practice.

Results 203 kidney transplants carried out between years 2010 to May 2018; of these 114 patients, whose data were complete, were tabulated. The Pearson Correlation was: −0.3 between RRT and PTBC time; −0.14 between PTBC and creatinine after TR; 0.09 between PTBC and RVU; of 0.14 between PTBC and IVU; the last 2 were urological complications after kidney transplant.

Conclusions  There is an inverse correlation between RRT Time and bladder capacity before transplantation, which influences the prognosis of the renal transplant patient, in terms of post-transplant renal function and urological complications due to VUR and UTI.

 
  • Referencias

  • 1 Hotta K, Miura M, Wada Y. , et al. Atrophic bladder in long-term dialysis patients increases the risk for urological complications after kidney transplantation. Int J Urol 2017; 24 (04) 314-319
  • 2 Chen J-L, Lee M-C, Kuo H-C. Reduction of cystometric bladder capacity and bladder compliance with time in patients with end-stage renal disease. J Formos Med Assoc 2012; 111 (04) 209-213
  • 3 Inoue T, Satoh S, Obara T. , et al. Cystometric evaluation of recovery in hypocompliant defunctionalized bladder as a result of long-term dialysis after kidney transplantation. Int J Urol 2016; 23 (08) 694-700
  • 4 Thuret R, Hurel S, Kleinclauss F, Timsit O. Lower urinary tract symptoms and pelvic floor dysfunction in renal transplant candidates and recipients. Prog Urol 2016; 26 (15) 114-1121
  • 5 Song M, Park J, Kim YH. , et al. Bladder capacity in kidney transplant patients with end-stage renal disease. Int Urol Nephrol 2015; 47 (01) 101-106
  • 6 Miyaoka R. Correlations between pretransplant dialysis duration, bladder capacity, and prevalence of vesicoureteral reflux to the graft. Int Braz J Urol 2011; 37: 551-552
  • 7 Ciszek M. Urological evaluation prior to renal transplantation. Cent European J Urol 2015; 68 (03) 383
  • 8 Silva DM, Prudente AC, Mazzali M, Borges CF, D'Ancona C. Bladder function evaluation before renal transplantation in nonurologic disease: is it necessary?. Urology 2014; 83 (02) 406-410
  • 9 Tsunoyama K, Ishida H, Omoto K, Shimizu T, Shirakawa H, Tanabe K. Bladder function of end-stage renal disease patients. Int J Urol 2010; 17 (09) 791-795
  • 10 Van der Weide MJ, Van Achterberg T, Smits JP, Heesakkers JP, Bemelmans BL, Hilbrands LB. Causes of frequency and nocturia after renal transplantation. BJU Int 2008; 101 (08) 1029-1034
  • 11 Blanco M, Medina J, Pamplona M. , et al. Outcome of renal transplantation in adult patients with augmented bladders. Transplant Proc 2009; 41 (06) 2382-2384
  • 12 Chun JM, Jung GO, Park JB. , et al. Renal transplantation in patients with a small bladder. Transplant Proc 2008; 40 (07) 2333-2335
  • 13 Zafarghandi RM, Naghibi M, Nazemian F, Sharifipoor F, Taghavi R. 333 A Comparison Of Augmentation Enterocystoplastyand Ureterocystoplasty Before Kidney Transplantation With Control Group. Eur Urol Suppl 2010; 9: 130
  • 14 Numakura K, Tsuchiya N, Tsuruta H. , et al. Efficacy and safety of bladder hydrodistension for decreased bladder capacity induced by intravesical BCG therapy. Scand J Urol 2016; 50 (06) 429-432
  • 15 Tsunoyama K, Ishida H, Shimizu T, Omoto K, Tanabe K. Improvement of urinary dysfunction after kidney transplantation by administration of the antimuscarinic agent--prospective randomized controlled study. Transplantation 2012; 93 (06) 597-602
  • 16 Filler G, Dave S. Is a reduction in cystometric bladder capacity in anuric infants post-renal transplant really no big deal?. Pediatr Transplant 2016; 20 (08) 1016-1017
  • 17 Alexopoulos S, Lightner A, Concepcion W, Rose M, Salcedo-Concepcion K, Salvatierra O. Pediatric kidney recipients with small capacity, defunctionalized urinary bladders receiving adult-sized kidney without prior bladder augmentation. Transplantation 2011; 91 (04) 452-456
  • 18 Capozza N, Torino G, Collura G. , et al. Renal transplantation in patients with “valve bladder”: is bladder augmentation necessary?. Transplant Proc 2010; 42 (04) 1069-1073
  • 19 Pereira PL, Urrutia MJM, Lobato R, Jaureguizar E. Renal transplantation in augmented bladders. Curr Urol Rep 2014; 15 (08) 431
  • 20 Herthelius M, Öborn H. Bladder dysfunction in children and adolescents after renal transplantation. Pediatr Nephrol 2006; 21 (05) 725-728
  • 21 Laftavi MR, Chaudhry Q, Kohli R. , et al. The role of ureteral stents for all ureteroneocystostomies in kidney transplants. Int J Organ Transplant Med 2011; 2 (02) 66-74