Urological complications after kidney transplantation

Kronična bubrežna bolest podrazumijeva oštećenje bubrežne strukture i funkcije zbog čega dolazi do progresivnog i trajnog oštećenja ekskrecijske, endokrine i metaboličke bubrežne funkcije. Dijaliza i transplantacija bubrega su suvremene metode nadomjesnog liječenja kronične bubrežne bolesti. Transplantacija bubrega je kirurški zahvat s mogućim komplikacijama. Svrha ovog rada je bila prikazati učestalost uroloških komplikacija nakon transplantacije bubrega te analizirati njihovo liječenje i ishod. Retrospektivno je analizirana medicinska dokumentacija bolesnika u kojih je od 30. siječnja 1971. godine do 31. prosinca 2019. godine u Kliničkom bolničkom centru Rijeka učinjena transplantacija bubrega te su posebno obrađene urološke komplikacije. Tijekom promatranog razdoblja učinjene su ukupno 1174 transplantacije bubrega. Urološke komplikacije imalo je ukupno 155 bolesnika (13,3%). Najčešće komplikacije su bile stenoza uretera kod 52 bolesnika (4,5%), urinarna fistula kod 50 bolesnika (4,3%), retencija urina kod 24 bolesnika (1,9%) te urolitijaza kod osam bolesnika (0,7%). Kod većine bolesnika je provedeno kirurško liječenje. U zadnje vrijeme se značajno povećalo rješavanje uroloških komplikacija korištenjem minimalno-invazivnih metoda. Rezultati ovog istraživanja pokazuju da urološke komplikacije nisu bile česte, a najčešće su bile stenoza uretera i urinarna fistula. Dio uroloških komplikacija liječen je konzervativnim, a dio kirurškim pristupom. Kod bolesnika kod kojih je potrebno kirurško liječenje, endourološke metode predstavljaju danas inicijalnu metodu liječenja.
Chronic kidney disease indicated the damage of renal structure and function which leads to progressive and permanent damage of excretory, endocrine and metabolic functions of kidney. The dialysis and kidney transplantation are modern methods of replacement treatment of chronic kidney disease. Kidney transplantation is a surgical procedure with possible complications. The purpose of this study was to show the frequency of urological complications after kidney transplantation and to analyze their treatment and outcome. The medical documentation of patients with kidney transplantion operated in University Hospital Centre Rijeka from 30st January 1971 to 31st December 2019, were retrospectively analyzed and urological complications were elaboreted. In the observed period, 1174 kidney transplantations were performed. Urological complications were noticed in the 155 patients (13,3%). The most frequent complications were ureteral stenosis in 52 patients (4,5%), urinary fistula in 50 patients (4,3%), urinary retention in 24 patients (1,9%) and urolithiasis in the eight patients (0,7%). The majority of the patients underwent surgical treatment. Recently, minimally invasive surgery was the method of choice for treatment of urological complications. The result of this study shows that urological complications were not frequent and the most frequent were ureteral stenosis and urinary fistula. Partly urological complications were treated conservatively and partly with surgical approach. In the group of patients that required surgical treatment, endourological methods are currently the initial treatment modality