Korean J Transplant.  2023 Nov;37(Suppl 1):S312. 10.4285/ATW2023.F-9228.

Association of reduced bladder capacity in the incidence of complicated urinary tract infection in kidney transplant recipients

• Laygo J
• Parayno A

• KMID: 2551941
• DOI: http://doi.org/10.4285/ATW2023.F-9228

Abstract

Background
End stage renal disease (ESRD) patients are prone to have decreased bladder capacity. Loss of physiological distention of the bladder results in reduction of its capacity. Poorly compliant bladder may result in increased incidence of urinary tract infection (UTI). The study aims to determine the incidence of UTI in kidney transplant recipients with reduced bladder capacity. Furthermore, the study aims to provide insight into the preoperative evaluation of kidney transplant recipients and decision to stenting.
Methods
A retrospective cohort study wherein patients who underwent kidney transplantation in National Kidney and Transplant Institute from January 1 to December 31, 2022 was conducted. Patients were classified into reduced bladder capacity group (RB) and normal bladder capacity group (NB). Patients who developed UTI in their first 3 months of transplantation were identified from each group. From the group with UTIs, patients with stents and with no stents were identified. Descriptive and inferential statistics were used utilizing Microsoft Excel statistical function. The statistical analysis used was chi-square test. Significance levels were defined as P-values less than 0.05.
Results
Of 314 kidney transplants performed, 245 recipients were included. One hundred twenty-three recipients were determined to have normal bladder capacity and 61 patients have a reduced bladder capacity. Incidence of UTI during the first 3 months of transplantation in NB group is 40% (49/123), while for RB group, incidence is 33% (20/ 61), P=0.222. However, the difference is nonsignificant. Regarding stent placement, five patients were stented in the NB group. Of those, 20% (1/5) developed UTI. In the RB group, 22 patients were stented, 27% (6/22) developed UTI. The incidence of UTI in stented patients in the NB and RB group is not statistically significant (P=0.128).
Conclusions
Successful kidney transplantation can be achieved in patients with reduced bladder capacity. The incidence of UTI between the NB and RB group is comparable. The need for preoperative bladder expansion can be elective and can be deemed unnecessary.