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Stent-related ureteric obstruction in paediatric renal transplantation

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Abstract

The rates of ureteric obstruction and complications for use of externally draining uretero-vesico-cutaneous (external) stents (Group 1: n=39) and the use of internal uretero-vesical (double-J) stents (Group 2: n=16), in 55 of 64 consecutive paediatric renal-transplant recipients, performed at our institution between January 1996 and December 2003, have been compared. Serum creatinine levels pre and post-operatively and pre and post-stent removal were recorded. The diagnosis of ureteric obstruction was based on an increase in serum creatinine of ≥20%, in conjunction with ultrasound evidence of hydronephrosis or hydroureter, where other causes of renal dysfunction were excluded. Ureteric obstruction occurred in 13 of the 39 patients (33.3%) in Group 1, compared with only one case of ureteric obstruction in the 16 patients (6.25%) in Group 2 (OR=7.5, 95% CI=0.8–70, P=0.038). There was no evidence of a difference in the number of urinary tract infections (9/39 in Group 1, 6/16 in Group 2, OR=0.5, 95% CI=0.14 to 1.8, P=0.275) or the mean length of hospital stay (10.9 days in Group 1, 10.1 days in Group 2, 95% CI=−2.3 to 4 days, P=0.565) between the two groups. Glomerular filtration rate (GFR) improved in the week after stent removal in Group 2, but deteriorated in Group 1 (P=0.07). This non-randomised comparison of stent types supports the use of prophylactic double-J stents in paediatric renal transplantation- in terms of decreased ureteric complications and improved renal function post-stent removal.

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Acknowledgements

We thank Suzi Maron for her help with the illustrations, Suzanna Vidmar for statistical co-ordination, and Vicki Burns for her help with the preParation of the manuscript.

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Authors and Affiliations

  1. Department of Nephrology, The Royal Children’s Hospital, Flemington Road, 3052, Parkville, Melbourne, VIC, Australia

    Catherine M. Simpson, Rowan G. Walker, David M. A. Francis, Amanda J. Robertson & Colin L. Jones

  2. Department of Social Medicine, University of Bristol, UK

    Jonathan A. C. Sterne

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  1. Catherine M. Simpson
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  2. Jonathan A. C. Sterne
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  4. David M. A. Francis
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Correspondence to Catherine M. Simpson.

Additional information

This work was presented in abstract/oral poster form at The Thirteenth Congress of the International Pediatric Nephrology Association in Adelaide, Australia, in August 2004

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Simpson, C.M., Sterne, J.A.C., Walker, R.G. et al. Stent-related ureteric obstruction in paediatric renal transplantation. Pediatr Nephrol 21, 79–85 (2006). https://doi.org/10.1007/s00467-005-2043-1

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  • DOI: https://doi.org/10.1007/s00467-005-2043-1

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