Native Hydronephrosis after Kidney Transplantation Relates to Urinary Bladder Urothelial Carcinoma: A Single Center Study
Cheng-Ju Ho, Shao-Chuan Wang, Wen-Jung Chen, Tzuo-Yi Hsieh, Wen-Wei Sung, Sung-Lang Chen
Department of Urology, Chung Shan Medical University Hospital, Taichung, Taiwan
Purpose: High incidence of urothelial carcinoma after kidney transplantation (KT) in Taiwan has been reported. We investigate the potential correlation between hydronephrosis and urinary bladder urothelial carcinoma (UBUC).
Materials and Methods: From 2003 to 2018, total 1005 received KT patients who followed up at Chung Shan Medical University Hospital (CSMUH) and 58 later diagnosed UTUC patients were enrolled in this retrospective study. Logistic regression models were conducted for multivariate analysis. Kaplan-Meier analysis for UBUC-free survival status, and log-rank test for curves statistical comparisons.
Average time from KT to UBUC was 7.0 ± 5.1years. There was significant difference in gender with female predominance in UBUC patients (63.8% versus 36.2%). In UBUC group, native hydronephrosis occurred more often compared with non-UBUC group (56.4% versus 6.4%, respectively, p<0.001). Graft kidney hydronephrosis showed no significant difference with UBUC (21.8% versus 23.2%, p=0.811). In multivariate analysis, native hydronephrosis presented significant factor of de novo UBUC with odd ratio of 16.033(95% CI, 8.660-29.683; p<0.001). The cumulative UBUC-free survival rates were significantly higher than no hydronephrosis group in Kaplan-Meier analysis.
Conclusions: Native hydronephrosis is significantly associated with de novo UBUC in post KT recipients in this cohort study. Compared with no hydronephrosis group, UBUC with native hydronephrosis showed similar tumor characteristics. Our results emphasize the importance of hydronephrosis during post-KT follow up, and offer a clinically applicable tool for UBUC detection.