Clinical Outcome of Long-Term Renal Transplant Survivors: A Nephrourologic Approach

BackgroundLong-term renal transplant survivors display high incidences of hypogonadism, neoplasms, erectile dysfunction, and metabolic syndrome. Although the urologist has a major role in the kidney transplantation surgery and treatment of the graft-related surgical complications, the follow-up of these patients is essentially focused on kidney function and the immunosuppressive regimen. We sought to evaluate the role of a nephrourologic follow-up for kidney transplant recipients.MethodsWe evaluated 27 male patients of mean age of 48.1 ± 7.5 years and mean renal allograft follow-up of 12.3 ± 4.3 years. The nephrourologic approach consisted of evaluation of the urinary system, prostate cancer screening, and assessment of voiding function, fertility, erectile dysfunction, hypogonadism, and metabolic syndrome. We also assessed quality of life.ResultsMajor urologic findings were found in 18 (66.7%) patients. Four patients reported posttransplantation parenthood. The mean serum creatinine was 1.5 ± 0.6 mg/dL and the calculated clearance, 72.6 ± 27.4 mL/min/1.73 m2. Regarding the voiding pattern, 92.6% of patients showed mild to moderate bladder outlet obstruction. Clinically significant increases in prostate volume were observed in 3.7% of patients. Mean serum total prostate-specific antigen was 1.6 ± 1.5 ng/mL. Erectile dysfunction was displayed by 46.2% and hypogonadism by 74.1% of patients. Metabolic syndrome was diagnosed in 44.4% of patients, and quality of life was generally rated as good (4/5).ConclusionLong-term renal transplantation survivors show high prevalences of treatable urologic diseases. Thus, we strongly recommend routine complete nephrourologic follow-up of this population.