Predictors of Vesicoureteral Reflux in the Pretransplant Evaluation of Patients with End-Stage Renal Disease

Abstract

INTRODUCTION[|]Voiding cystourethrography (VCUG) is widely performed in the pretransplant evaluation of patients with a history of urological disorders to detect vesicoureteral reflux (VUR). The aim of this study was to evaluate the relationship between the primary etiology of end-stage renal disease (ESRD) and the prevalence of VUR, thereby determining the necessity for VCUG in pretransplant patients.[¤]METHODS[|]A total of 319 pretransplant cases that underwent VCUG were retrospectively reviewed.[¤]RESULTS[|]VCUG revealed VUR in 53 (16.6%) cases. VUR was left-sided in 21 (41.2%), right-sided in 18 (35.3%), and bilateral in 12 (3.8%), and grade 1 in 10 (19.6%), grade 2 in 19 (37.3%), grade 3 in 20 (39.2%), and grade 4 in 2 (3.9%). The etiology of ESRD was hypertension in 125 (39.2%), diabetes mellitus (DM) in 46 (14.4%), polycystic kidney disease (PKD) in 21 (6.6%), amyloidosis in 16 (5%), VUR in 11 (3.4%), and glomerulonephritis (GN) in 11 (3.4%). The incidence of VUR was significantly higher in female patients. Hypertension, DM, PKD, amyloidosis, and GN were not found to predict VUR. The rate of abnormal VCUG findings was similar in cases with secondary and idiopathic ESRD.[¤]DISCUSSION AND CONCLUSION[|]The findings demonstrate that only sex was a predictor of VUR in pretransplant cases. The presence of VUR was not related to any cause of ESRD; therefore, VCUG is not needed in all cases as a part of pretransplant evaluation.[¤]

Keywords

• renal transplantation
• vesicoureteral reflux; voiding cystourethrography.