Outcome of pediatric renal transplantation in urological versus non-urological causes of end stage renal disease: Does it matter?

Autor: Hussein AA; Department of Urology, Cairo University, Egypt. Electronic address: ahmedalyhussein@kasralainy.edu.eg., Shoukry AI; Department of Urology, Cairo University, Egypt., Fadel F; Department of Pediatric Nephrology, Cairo University, Egypt., Morsi HA; Department of Urology, Cairo University, Egypt., Hussein HA; Department of Urology, Cairo University, Egypt., Sheba M; Department of Urology, Cairo University, Egypt., El-Khateeb N; Department of Urology, Cairo University, Egypt., Abou-El Ela W; Department of Urology, Cairo University, Egypt., El-Sheemy M; Department of Urology, Cairo University, Egypt., Daw K; Department of Urology, Cairo University, Egypt., Shouman A; Department of Urology, Cairo University, Egypt., Lotfy A; Department of Urology, Cairo University, Egypt., Badawy H; Department of Urology, Cairo University, Egypt., Eissa M; Department of Urology, Cairo University, Egypt.
Jazyk: angličtina
Zdroj: Journal of pediatric urology [J Pediatr Urol] 2018 Apr; Vol. 14 (2), pp. 166.e1-166.e7. Date of Electronic Publication: 2017 Nov 20.
DOI: 10.1016/j.jpurol.2017.10.015
Abstrakt: Introduction: Causes for end stage renal disease (ESRD) in children can be categorized into urological causes or non-urological causes. We sought to compare the outcomes of urological and non-urological causes of ESRD in children.
Methods: Patients were divided into two groups: urological causes of ESRD versus non-urological causes of ESRD. All patients and donors had at least 6 months of follow-up. The main outcomes included the effect on complications and renal function. Comparisons were carried out using the chi-square test or the Student t-test. Multivariate logistic regression analysis was used to define the effect of different variables on the outcome of renal transplantation (Table).
Results: Our study included 123 patients, 91 males. The mean age was 9 years and mean follow up was 46 months. Two-thirds of the patients had non-urological causes of ESRD. Overall survival was 100%, and only one patient needed a graft nephrectomy 3 months after the transplant. The mean estimated glomerular filtration rate was 117 mL/min, and did not differ significantly between the two groups (p = 0.13). Multivariable regression showed that female gender (OR 8.7, 95% CI 2.9-26, p = 0 0.0001) was associated with better renal function, while having a urological cause of ESRD (OR 0.28, CI 0.08-0.98, p = 0 0.05) was associated with worse renal function. Non-urological causes of ESRD were significantly less likely to develop complications following renal transplantation (OR 0.28, CI 0.09-0.89, p = 0 0.03).
Conclusion: Female patients with non-urological causes of ESRD are more likely to have better long-term renal functions, and less liable to develop complications following renal transplant.
(Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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