To assess renal function, graft survival rates and the risk of graft loss in children based on the etiology with focus on differences between urologic causes from congenital anomalies of the kidney and urinary tract (CAKUT) versus other causes of end-stage kidney disease (ESKD).

A retrospective chart review was performed that included patients <18 years of age who underwent a kidney transplant at our institution from December 1984 to November 2010 with the last follow-up recorded in March 2018. Patient clinical characteristics, demographics, and ESKD etiology were recorded. Patients were divided into two groups, urologic (CAKUT) versus non-urologic based on the etiology of ESKD and survival analysis was performed.

A total of 112 kidney transplants were analyzed; 90 (80.4%) were due to non-urologic causes and 22 (19.6%) were due to urologic causes. The median age at transplant was 12 [7-15] years. Median graft survival time was not statistically different according to the ESKD etiology (non-urologic = 12 years, 95% CI: 10.01-13.99 vs. urologic = 16 years, 95% CI: 7.59-24.41; p=0.532). There was a significant risk of graft loss in patients with urinary tract infections (UTI) after transplant (HR=3.15, 95% CI: 1.59-6.25; p=0.001).

Children requiring transplant due to urologic causes have no disadvantage in graft survival compared to children with ESKD from other causes. Patients with UTI after transplant had a higher rate of graft loss.

The Journal of urology. 2019 Sep 05 [Epub ahead of print]

Mona S Jahromi, Maria C Velasquez, Ruben Blachman-Braun, Rafael Gosalbez, Miguel Castellan, Andrew Labbie, Gaetano Ciancio, Jayanthi Chandar, Alireza Alam

Department of Urology, University of Miami Miller School of Medicine, Miami, Florida., Department of Surgery, Miami Transplant Institute, University of Miami/Jackson Memorial Hospital, Miami, Florida., Pediatric Kidney Transplant, Miami Transplant Institute, Miami, Florida.