Haematuria has a prevalence of 12% in the postrenal transplant patient population. It heralds potentially dangerous causes which could threaten graft loss. It is important to consider causes in light of the unique, urological, and immunological standpoints of these patients.
We review the literature on common causes of haematuria in postrenal transplant patients and suggest the salient approach to the evaluation of this condition. A major cause of haematuria is urinary tract infections. There should be a higher index of suspicion for mycobacterial, fungal, and viral infection in this group of immunosuppressed patients. Measures recommended in the prevention of urinary tract infections include early removal of foreign bodies as well as prophylactic antibiotics during the early transplant phase.
Another common cause of haematuria is that of malignancies, in particular, renal cell carcinomas. When surgically managing cancer in the setting of a renal transplant, one has to be mindful of the limited retropubic space and the need to protect the anastomoses. Other causes include graft rejections, recurrences of primary disease, and calculus formation. It is important to perform a comprehensive evaluation with the aid of an experienced multidisciplinary transplant team.
Biomed Res Int. 2015;2015:292034. doi: 10.1155/2015/292034. Epub 2015 Mar 30.
Wang Z1, Vathsala A2, Tiong HY3.
1 Department of Urology, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074.
2 Division of Nephrology, Department of Medicine, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074 ; National University Centre for Organ Transplantation, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074.
3 Department of Urology, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074 ; National University Centre for Organ Transplantation, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074.