Evaluation of complications in kidney transplant patients: late versus early ureteral stent removal.

A single-center observational study.

Abstract

Introduction: Improvements in surgical techniques for kidney transplant management have prolonged graft survival, but urological complications leading to postoperative morbidity and impaired graft function are common. These complications are related to using urinary tract devices, such as ureteral stents. This study aimed to characterize the infectious and surgical urological complications associated with early or late ureteral stent removal.

Methods: This observational study was conducted at the Carlos Andrade Marín Specialty Hospital in Quito, Ecuador, from 2018 to 2022. Kidney transplant patients with a 6-month follow-up were included. The variables studied were age, sex, cause of kidney disease, residual urine output, type of kidney transplant donor, infectious complications, and surgical complications. The dependent variable was late versus early ureteral stent removal. Descriptive and inferential statistics were used.

Results: A total of 231 cases were enrolled in the study, 139 (60.17%) with late withdrawal and 92 with early withdrawal (39.82%). 57% of patients were men, and the mean age was 45.6 ± 14.1 years. The cause of kidney disease was unknown in 41.9%, followed by hypertensive nephropathy (14.7%), glomerulopathy (12.5%), and diabetic nephropathy (7.7%); 32.9% maintained residual urine output, late withdrawal (independent ureteral stent and urinary catheter) was performed in 60.17%, and early withdrawal (ureteral stent attached to the urinary catheter) in 39.82%. Urinary tract infection occurred in 47% of patients with late removal and 42% with early removal (P > 0.05). E. coli was isolated in 46.15% of cases, Klebsiella pneumoniae in 10.73%, and the pathogen was not identified in 33.8%. The prevalence of surgical urological complications with late removal was 26% and 7% with early removal.

Conclusion: Infectious urological complications were similar with early and late removal, but surgical complications were more prevalent with late removal.