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Kidney Week

Abstract: PO2004

Outcome of a 30-Month Screening, Education, and Treatment Program of Lower Urinary Tract (Dys)Function in Pediatric Kidney Recipients

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • de Wall, Liesbeth L., Radboudumc, Nijmegen, Gelderland, Netherlands
  • Glaap-Roeven, Femke, Radboudumc, Nijmegen, Gelderland, Netherlands
  • Bootsma-Robroeks, Charlotte M.H.H.T., Radboudumc, Nijmegen, Gelderland, Netherlands
Background

Graft survival of pediatric kidney recipients increased dramatically over the past decades. Lower urinary tract disfunction (LUTD), as one of the factors that might contribute to graft function and survival, is seen in the majority of all recipients despite cause of kidney failure. This study presents the 30 months outcomes of a screening and early intervention program of all pediatric kidney recipients.

Methods

Since June 2018 all pediatric renal recipients underwent an active screening and education for LUTD pre-and post-transplant by our nurse specialist. Personalized education was given to all and urotherapy in case of LUTD. Those without LUTD, received yearly re-evaluation.

Results

A total of 56 recipients are screened thus far, aged 11.8±4.4yrs. Mean±SD time after transplant was 4.4±3.9yrs. After initial screening, LUTD was present in 71% of the patients (Table 1). Maximal bladder capacity exceeded in 59%, abnormal uroflowmetry was present in 58%, and residual voiding was present in 37% of the children. Longitudinal data showed that 16% remained dysfunctional despite urotherapy. In addition, 60% switched between a functional and dysfunctional pattern. Overall, after 30 months, 48% of the children with LUTD developed a persistent functional voiding pattern. Recipients with LUTD significantly needed more health care activities (2-6 times more compared to patients without LUTD). By consequence economic burden rises with €6000,- per patient each year.

Conclusion

LUTD is present in the majority of pediatric kidney recipients, regardless of the cause of kidney failure. Due to LUTD, patients need more health care. Resulting in a significant economic and psycho-social burden. This pro-active screening, treatment and education uro-transplant program was effective in 48% of the children with LUTD in the long term. A longer follow-up time is needed in order to analyze the impact on graft survival and cost-effectiveness.

Funding

  • Government Support – Non-U.S.