BLADDER AUGMENTATION CAN BE PROBLEMATIC WITH RENAL-FAILURE AND TRANSPLANTATION

Ten consecutive patients; with failure of urinary bladder augmentation (UBA) performed either prior to or after reaching end-stage renal dis ease (ESRD) were studied, Seven patients developed increased hydrouret eronephrosis, infectious complications, and advanced to ESRD after UBA . The mean time to development of ESRD in patients who had UBA perform ed with moderate chronic renal failure (CRF) was 1.8 years. The UBAs i n all seven patients were taken down prior to transplantation. Subsequ ently, five of these UBA-takedown patients have received kidney grafts and all have stable, good renal function, Three patients had their UB A performed after they reached ESRD, in preparation for renal transpla ntation. AII three of these patients experienced recurrent urosepsis f ollowing transplantation, resulting in death in one patient and loss o f graft in another, The third patient will undergo takedown of the UBA , This study suggests that UBA may possibly not be the best option for patients with moderate CRF and those awaiting transplantation.