Bladder dysfunction and end stage renal disease

Abstract

Introduction and objectives:Evaluation of lower urinary tract function inpatients with end-stage renal disease and lowerurinary tract symptoms. Patients were screenedbefore entering a renal transplantationprogram.Materials and methods: A diagnosticwork-up including urodynamics was performed on52 patients (14 women, 38 men) suffering fromrenal failure due to chronic glomerulonephritis(n = 25), diabetic nephropathy (n = 15), chronicpyelonephritis/stone disease (n = 9) andpolycystic kidney disease (n = 3).Results: Abnormalities in lowerurinary tract function of different degreeswere found in 40 patients (77%). Majorproblems are bladder hypersensitivity (n = 31%),poor bladder compliance (38%), detrusorinstability (25%) and detrusor-sphincterdyssynergia (33%).Conclusions: There is a highincidence of bladder dysfunction of differentdegrees in patients with renal failure. Theclinical significance, especially in the longterm, needs to be evaluated. However, aurodynamic assessment before renaltransplantation is recommended in all patientsreporting symptoms of dysfunctional voidingand/or bladder storage problems in order toavoid allograft dysfunction due to chronicbladder dysfunction and related complications.Depending on the degree of bladder dysfunctionan urodynamic follow-up after transplantationis necessary. If there are no symptoms and nohistory if lower urinary tract dysfunction anurodynamic assessment is not necessary.