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Background <p>Kidney transplantation (KT) is the preferred treatment for pediatric patients with kidney failure. However, vesicoureteral reflux (VUR) is a common occurrence post-KT. This single-center retrospective cohort study investigated bladder capacity changes and identified post-transplant VUR predictors in pediatric KT recipients.</p> Methods <p>Pediatric patients with or without pre-transplant anuria (&lt; 0.5&#xa0;mL/kg/h) who underwent KT, from January 2009 to December 2023, were analyzed. Expected bladder capacity (EBC) was calculated based on age. Maximum bladder capacity (MBC) and post-transplant VUR presence were evaluated using voiding cystourethrography. Logistic regression was used to identify independent risk factors for post-transplant VUR. Receiver operating characteristic curve analysis was used to determine the predicted probability of post-transplant VUR.</p> Results <p>Among 93 patients (males: 60%; median age: 6.1 [2.3–17.7] years), 25 (26.9%) had pre-transplant anuria. Bladder capacity (from 37.5 to 120&#xa0;mL; <i>p</i> &lt; 0.001) and MBC/EBC ratio (from 19.7 to 62.3%; <i>p</i> &lt; 0.001) increased post-KT only in patients with anuria. Multivariate analyses revealed that pre-transplant MBC/EBC ratio predicted post-transplant VUR (odds ratio: 0.982, 95% confidence interval: 0.963–0.999; <i>p</i> = 0.046; sensitivity: 76.5%, specificity: 72.4%, area under the curve: 0.757 [cut-off: 57.8%]).</p> Conclusions <p>Pre-transplant MBC/EBC ratio is a useful bladder capacity indicator and predicts post-transplant VUR in pediatric KT recipients.</p> Graphical Abstract <p></p>

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Change in bladder capacity and prognostic predictors of post-transplant vesicoureteral reflux in pediatric kidney transplant recipients: a single-center retrospective cohort study

  • 期刊论文

  • 发表日期：

    2025年12月8日

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  • Yujiro Aoki,
  • Yuko Hamasaki,
  • Junya Hashimoto,
  • Maho Maeda,
  • Kei Sakurabayashi,
  • Takashi Yonekura,
  • Yoshihiro Itabashi,
  • Masaki Muramatsu,
  • Takeshi Kawamura,
  • Seiichiro Shishido,
  • Ken Sakai

摘要

Background

Kidney transplantation (KT) is the preferred treatment for pediatric patients with kidney failure. However, vesicoureteral reflux (VUR) is a common occurrence post-KT. This single-center retrospective cohort study investigated bladder capacity changes and identified post-transplant VUR predictors in pediatric KT recipients.

Methods

Pediatric patients with or without pre-transplant anuria (< 0.5 mL/kg/h) who underwent KT, from January 2009 to December 2023, were analyzed. Expected bladder capacity (EBC) was calculated based on age. Maximum bladder capacity (MBC) and post-transplant VUR presence were evaluated using voiding cystourethrography. Logistic regression was used to identify independent risk factors for post-transplant VUR. Receiver operating characteristic curve analysis was used to determine the predicted probability of post-transplant VUR.

Results

Among 93 patients (males: 60%; median age: 6.1 [2.3–17.7] years), 25 (26.9%) had pre-transplant anuria. Bladder capacity (from 37.5 to 120 mL; p < 0.001) and MBC/EBC ratio (from 19.7 to 62.3%; p < 0.001) increased post-KT only in patients with anuria. Multivariate analyses revealed that pre-transplant MBC/EBC ratio predicted post-transplant VUR (odds ratio: 0.982, 95% confidence interval: 0.963–0.999; p = 0.046; sensitivity: 76.5%, specificity: 72.4%, area under the curve: 0.757 [cut-off: 57.8%]).

Conclusions

Pre-transplant MBC/EBC ratio is a useful bladder capacity indicator and predicts post-transplant VUR in pediatric KT recipients.

Graphical Abstract