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  • Title: Outcome of pediatric renal transplantation in urological versus non-urological causes of end stage renal disease: Does it matter?
    Author: Hussein AA, Shoukry AI, Fadel F, Morsi HA, Hussein HA, Sheba M, El-Khateeb N, Abou-El Ela W, El-Sheemy M, Daw K, Shouman A, Lotfy A, Badawy H, Eissa M.
    Journal: J Pediatr Urol; 2018 Apr; 14(2):166.e1-166.e7. PubMed ID: 29223859.
    Abstract:
    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.
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