Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation
Yıl: 2020 Cilt: 36 Sayı: 1 Sayfa Aralığı: 33 - 38 Metin Dili: İngilizce DOI: 10.5578/turkjsurg.4605 İndeks Tarihi: 09-11-2020
Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation
Öz: Objective: Major urinary complications such as urinary leaks, stenosis or urinary tract infections after kidney transplantation can lead to graft or patientloss. The effect of peritoneal dialysis on post-kidney transplantation complications have been discussed but its effect on ureteral stenosis is unknown.In this study, it was aimed to analyze factors effecting major ureteral complications after living donor kidney transplantation and impact of peritonealdialysis and double J-stents (JJ stents).Material and Methods: This study included 116 adult to adult living donor kidney transplant patients. Factors effecting major urologic complicationsafter living donor kidney transplantation were analyzed. The donors were primary relatives of the recipients.Results: Major urologic complications after living donor kidney transplantation was 8/116 (6.9%). Urinary leak was present in 2 (1.7%) patients. Ureteralstenosis was encountered in 6 (5.2%) patients. Double J stents were used in 84 (72.4%) of the cases. The effect of JJ ureteral stent was not statistically significant for urinary leak, ureteral stenosis (p= 0.074, p= 0.470, respectively). A total of 29 (25%) patients had peritoneal dialysis before kidney transplantation.Preoperative peritoneal dialyses and bacteriuria after kidney transplantation were independent risk factors for ureteral stenosis in multivariate analysis (p=0.013, and p= 0.010 respectively).Conclusion: In the guidance of the results of the present study, peritoneal dialysis prior to kidney transplantation and bacteriuria are independentrisk factors for ureteral stenosis after living donor kidney transplantation. JJ stents have no effect on urologic complications after living donor kidneytransplantation.
Anahtar Kelime: Böbrek nakli öncesi periton diyalizi erişkin canlı vericili böbrek nakli sonrası üreteral stenoz için risk faktörü müdür?
Öz: Giriş ve Amaç: Böbrek nakli sonrası oluşan üriner kaçak, üreteral darlık veya idrar yolu infeksiyonları gibi majör ürolojik komplikasyonlar greft veya hasta kaybına neden olabilir. Periton diyalizinin böbrek nakli sonrası komplikasyonlar üzerine etkisi tartışılmıştır ancak üreteral darlık üzerindeki etkisi bilinmemektedir. Bu çalışmada, canlı vericili böbrek nakli sonrası majör ürolojik komplikasyonlara etki eden faktörleri ve periton diyalizi ve double J-stentlerin (JJ stentler) etkisini analiz etmek amaçlanmıştır. Gereç ve Yöntem: Bu çalışma canlı vericili böbrek nakli yapılan 116 hastayı içermektedir. Çalışmada, canlı vericili böbrek nakli sonrası majör ürolojik komplikasyonları etkileyen faktörler analiz edildi. Donörler, alıcıların birincil akrabaları idi. Bulgular: Canlı vericili böbrek nakli sonrası majör ürolojik komplikasyonlar 8/116 (%6,9) idi. İki (%1,7) hastada üriner kaçak, 6 (%5,2) hastada üreteral darlık saptanmış, 84 (%72,4) olguda JJ stent kullanılmıştır. Üriner kaçak, üreteral darlık açısından JJ stent kullanımının istatistiksel olarak anlamlı bir etkisi saptanmamıştır (p= 0,074, p= 0,470). Toplam 29 (%25) hastada böbrek nakli öncesi periton diyalizi öyküsü vardı. Preoperatif periton diyalizi ve böbrek nakli sonrası bakteriüri, multivaryant analizde üreteral darlık için bağımsız risk faktörleri olarak saptanmıştır (p= 0,013 ve p= 0,010). Sonuç: Bu çalışmanın sonuçlarında canlı vericili böbrek nakli öncesi hastalarda periton diyalizi öyküsünün ve nakil sonrası bakteriürinin olması, nakil sonrası üreteral darlık için bağımsız risk faktörleri olarak saptanmıştır. Canlı vericili böbrek nakli sonrası ürolojik komplikasyonlar üzerine JJ stentlerin etkisi saptanmamıştır.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Sui W, Lipsky MJ, Matulay JT, Robins DJ, Onyeji IC, James MB, et al. Timing and predictors of early urologic and infectious complications after renal transplant: an analysis of a New York Statewide Database. Exp Clin Transplant 2018;16(6):665-70. [CrossRef]
- 2. Emiroğlu R, Karakayal H, Sevmiş S, Akkoç H, Bilgin N, Haberal M. Urologic complications in 1275 consecutive renal transplantations. Transplant Proc 2019;33(1-2):2016-17. [CrossRef]
- 3. Davari HR, Yarmohammadi H, Malekhosseini SA, Salahi H, Bahador A, Salehipour M. Urological complications in 980 consecutive patients with renal transplantation. Int J Urol 2006;13(10):1271-5. [CrossRef]
- 4. Whang M, Yballe M, Geffner S, Fletcher HS, Palekar S, Mulgaonkar S. Urologic complications in more than 2500 kidney transplantations performed at the Saint Barnabas healthcare system. Transplant Proc 2011;43(5):1619-22. [CrossRef]
- 5. Neri F, Tsivian M, Coccolini F, Bertelli R, Cavallari G, Nardo B, et al. Urological complications after kidney transplantation: experience of more than 1000 transplantations. Transplant Proc 2009;41(4):1224-6. [CrossRef]
- 6. Alberts VP, Idu MM, Legemate DA, Laguna Pes MP, Minnee RC. Ureterovesical anastomotic techniques for kidney transplantation: a systematic review and meta-analysis. Transpl Int 2014;27(6):593-605. [CrossRef]
- 7. Sözen H, Onaran M, Özen O, Dalgıç A. Urologic complications after renal transplant: a single-center experience. Exp Clin Transplant 2017. [CrossRef]
- 8. Abrol N, Dean PG, Prieto M, Stegall MD, Taner T. Routine stenting of extravesical ureteroneocystostomy in kidney transplantation: a systematic review and meta-analysis. Transplant Proc 2018;50(10):3397- 404. [CrossRef]
- 9. Kırnap M, Boyvat F, Torgay A, Moray G, Yıldırım S, Haberal M. Incidence of urinary complications with double J stents in kidney Ttransplantation. Exp Clin Transplant 2019;17(Suppl 1):148-52. [CrossRef]
- 10. Mangus RS, Haag BW. Stented versus nonstented extravesical ureteroneocystostomy in renal transplantation: a meta-analysis. Am J Transplant 2004;4(11):1889-96. [CrossRef]
- 11. Bzoma B, Kostro J, Hellmann A, Chamienia A, Hac S, Debska-Slizien A, et al. Ureteric stenting in kidney transplant recipients, gdansk centre experience, Poland. Transplant Proc 2018;50(6):1858-62. [CrossRef]
- 12. Tavakoli A, Surange RS, Pearson RC, Parrott NR, Augustine T, Riad HN. Impact of stents on urological complications and health care expenditure in renal transplant recipients: results of a prospective, randomized clinical trial. J Urol 2007;177(6):2260-4. [CrossRef]
- 13. Harza M, Baston C, Preda A, Olaru V, Ismail G, Domnisor L, et al. Impact of ureteral stenting on urological complications after kidney transplantation surgery: a single-center experience. Transplant Proc 2014;46(10):3459-62. [CrossRef]
- 14. Fayek SA, Keenan J, Haririan A, Cooper M, Barth R, Schweitzer E, et al. Ureteral stents are associated with reduced risk of ureteral complications after kidney transplantation. Transplantation 2012;93(3):304-8. [CrossRef]
- 15. Dominguez J, Clase CM, Mahalati K, MacDonald A, McAlister V, Belitsky P, et al. Is routine ureteric stenting needed in kidney transplantation? A randomized trial. Transplantation 2000;70(4):597-601. [CrossRef]
- 16. Chordia P, Schain D, Kayler L. Effects of ureteral stents on risk of bacteriuria in renal allograft recipients. Transpl Infect Dis 2013;15(3):268-75. [CrossRef]
- 17. Kumar A, Verma BS, Srivastava A, Bhandari M, Gupta A, Sharma R. Evaluation of the urological complications of living related renal transplantation at a single center during the last 10 years: impact of the Double-J stent. J Urol 2000;164(3 Pt 1):657-60. [CrossRef]
- 18. Haberal M, Boyvat F, Akdur A, Kırnap M, Özçelik Ü, Yarbuğ Karakayalı F. Surgical complications after kidney transplantation. Exp Clin Transplant 2016;14(6):587-95. [CrossRef]
- 19. Che X, Yang X, Yan J, Yuan Y, Ma Q, Ying L, et al. Effects of pretransplant peritoneal vs hemodialysis modality on outcome of first kidney transplantation from donors after cardiac death. BMC Nephrol 2018;19(1):235. [CrossRef]
- 20. Debska-Slizien A, Bobkowska-Macuk A, Bzoma B, Moszkowska G, Milecka A, Zadroznyc D, et al. Paired analysis of outcomes after kidney transplantation in peritoneal and hemodialysis patients. Transplant Proc 2018;50(6):1646-53. [CrossRef]
- 21. Prasad N, Vardhan H, Baburaj VP, Bhadauria D, Gupta A, Sharma RK, et al. Do the outcomes of living donor renal allograft recipients differ with peritoneal dialysis and hemodialysis as a bridge renal replacement therapy? Saudi J Kidney Dis Transpl 2014;25(6):1202-9. [CrossRef]
- 22. Dipalma T, Fernandez-Ruiz M, Praga M, Polanco N, Gonzalez E, Gutierrez-Solis E, et al. Pre-transplant dialysis modality does not influence short- or long-term outcome in kidney transplant recipients: analysis of paired kidneys from the same deceased donor. Clin Transplant 2016;30(9):1097-107. [CrossRef]
- 23. Ayar Y, Ersoy A, Ocakoglu G, Gullulu E, Kagızmanlı H, Yıldız A, et al. Encapsulating peritoneal sclerosis in peritoneal dialysis patients after kidney transplantation. Transplant Proc 2018;50(1):160-4. [CrossRef]
- 24. Benedetti E, Troppmann C, Gillingham K. Short and long-term outcomes of kidney transplants with multiple renal arteries. Ann Surg 1995;221:406-10. [CrossRef]
- 25. El-Mekresh M, Osman Y, Ali-El-Dein B, El-Diasty T, Ghoneim MA. Urological complications after living-donor renal transplantation. BJU Int 2001;87(4):295-306. [CrossRef]
- 26. Karam G, Hetet JF, Maillet F, Rigaud J, Hourmant M, Soulillou JP, et al. Late ureteral stenosis following renal transplantation: risk factors and impact on patient and graft survival. Am J Transplant 2006;6(2):352-6. [CrossRef]
- 27. Rahnemai-Azar AA, Gilchrist BF, Kayler LK. Independent risk factors for early urologic complications after kidney transplantation. Clin Transplant 2015;29(5):403-8. [CrossRef]
- 28. Fuller TF, Deger S, Büchler A, Roigas J, Schönberger B, Schnorr D, et al. Ureteral complications in the renal transplant recipient after laparoscopic living donor nephrectomy. Eur Urol 2006;50(3):535-41. [CrossRef]
- 29. Englesbe MJ, Dubay DA, Gillespie BW, Moyer AS, Pelletier SJ, Sung RS, et al. Risk factors for urinary complications after renal transplantation. Am J Transplant 2007;7(6):1536-41. [CrossRef]
| APA | kutlutürk k, SAHIN T, Cimen S, DALDA Y, Gonultas F, DOGAN S, ALTUNIŞIK TOPLU S, Unal B, PISKIN T (2020). Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation. , 33 - 38. 10.5578/turkjsurg.4605 |
| Chicago | kutlutürk koray,SAHIN TEVFIK TOLGA,Cimen Serhan,DALDA YASİN,Gonultas Fatih,DOGAN SAIT MURAT,ALTUNIŞIK TOPLU SİBEL,Unal Bulent,PISKIN TURGUT Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation. (2020): 33 - 38. 10.5578/turkjsurg.4605 |
| MLA | kutlutürk koray,SAHIN TEVFIK TOLGA,Cimen Serhan,DALDA YASİN,Gonultas Fatih,DOGAN SAIT MURAT,ALTUNIŞIK TOPLU SİBEL,Unal Bulent,PISKIN TURGUT Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation. , 2020, ss.33 - 38. 10.5578/turkjsurg.4605 |
| AMA | kutlutürk k,SAHIN T,Cimen S,DALDA Y,Gonultas F,DOGAN S,ALTUNIŞIK TOPLU S,Unal B,PISKIN T Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation. . 2020; 33 - 38. 10.5578/turkjsurg.4605 |
| Vancouver | kutlutürk k,SAHIN T,Cimen S,DALDA Y,Gonultas F,DOGAN S,ALTUNIŞIK TOPLU S,Unal B,PISKIN T Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation. . 2020; 33 - 38. 10.5578/turkjsurg.4605 |
| IEEE | kutlutürk k,SAHIN T,Cimen S,DALDA Y,Gonultas F,DOGAN S,ALTUNIŞIK TOPLU S,Unal B,PISKIN T "Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation." , ss.33 - 38, 2020. 10.5578/turkjsurg.4605 |
| ISNAD | kutlutürk, koray vd. "Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation". (2020), 33-38. https://doi.org/10.5578/turkjsurg.4605 |
| APA | kutlutürk k, SAHIN T, Cimen S, DALDA Y, Gonultas F, DOGAN S, ALTUNIŞIK TOPLU S, Unal B, PISKIN T (2020). Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation. Turkish Journal of Surgery, 36(1), 33 - 38. 10.5578/turkjsurg.4605 |
| Chicago | kutlutürk koray,SAHIN TEVFIK TOLGA,Cimen Serhan,DALDA YASİN,Gonultas Fatih,DOGAN SAIT MURAT,ALTUNIŞIK TOPLU SİBEL,Unal Bulent,PISKIN TURGUT Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation. Turkish Journal of Surgery 36, no.1 (2020): 33 - 38. 10.5578/turkjsurg.4605 |
| MLA | kutlutürk koray,SAHIN TEVFIK TOLGA,Cimen Serhan,DALDA YASİN,Gonultas Fatih,DOGAN SAIT MURAT,ALTUNIŞIK TOPLU SİBEL,Unal Bulent,PISKIN TURGUT Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation. Turkish Journal of Surgery, vol.36, no.1, 2020, ss.33 - 38. 10.5578/turkjsurg.4605 |
| AMA | kutlutürk k,SAHIN T,Cimen S,DALDA Y,Gonultas F,DOGAN S,ALTUNIŞIK TOPLU S,Unal B,PISKIN T Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation. Turkish Journal of Surgery. 2020; 36(1): 33 - 38. 10.5578/turkjsurg.4605 |
| Vancouver | kutlutürk k,SAHIN T,Cimen S,DALDA Y,Gonultas F,DOGAN S,ALTUNIŞIK TOPLU S,Unal B,PISKIN T Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation. Turkish Journal of Surgery. 2020; 36(1): 33 - 38. 10.5578/turkjsurg.4605 |
| IEEE | kutlutürk k,SAHIN T,Cimen S,DALDA Y,Gonultas F,DOGAN S,ALTUNIŞIK TOPLU S,Unal B,PISKIN T "Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation." Turkish Journal of Surgery, 36, ss.33 - 38, 2020. 10.5578/turkjsurg.4605 |
| ISNAD | kutlutürk, koray vd. "Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation". Turkish Journal of Surgery 36/1 (2020), 33-38. https://doi.org/10.5578/turkjsurg.4605 |
