Risk Factors Associated With High Post-Void Residual Urine and Urethral Re-Catheterization in the Early Postoperative Period Following Kidney Transplantation

Abstract

Aim: This study investigated the risk factors for both high post-void residual (PVR) and the need for urinary re-catheterization (RC) following kidney transplantation (KT). Our objectives were to develop a predictive risk model for high PVR and to outline a management strategy for patients who experience posttransplant elevated PVR. Methods: This prospective study included 110 adult patients who underwent KT. High PVR was defined as > 150 mL in non-anuric patients and > 50 mL in anuric patients. Logistic regression analysis was conducted to identify predictive factors for high PVR. Urinary RC was evaluated as a secondary outcome. Results: High PVR was observed in 31 (28.2%) patients. On multivariate analysis, DM (odds ratio [OR], 3.11; 95% confidence interval [CI], 1.22–7.94; p = 0.02) and anuria before transplantation (OR, 3.80; 95% CI, 1.34–10.80; p = 0.01) were identified as significant predictors of high PVR. The area under the curve of the receiver operating characteristic for the risk model using these factors was 0.72 (95% CI, 0.61–0.82). Urinary RC was required in 14 (12.7%) patients, and among male recipients, those who required RC due to high PVR had significantly larger prostate volume (p = 0.003). Conclusions: The present study demonstrated that DM and anuria are predictive factors for high PVR and larger prostate volume in male recipients was associated with an increased likelihood of RC. To prevent the following complications, PVR should be routinely measured especially in patients with a history of diabetes or anuria.