The Whitaker test, a useful tool in renal grafts?

Objectives. To evaluate the Whitaker test, a pressure flow examination, for its prognostic value in dilated renal transplants because urologic complic ations, such as ureteral stenosis, are significant problems after kidney tr ansplantation. Methods. Twenty-five patients with obstruction of the renal transplant and subsequent percutaneous nephrostomy were evaluated with a urodynamic pressu re flow test (Whitaker test) in combination with antegrade pyeloureterograp hy, The results of the Whitaker test were related to the serum creatinine v alues. Results. The Whitaker test demonstrated normal pressure flow (less than 15 cm H2O) in 7 patients, pressure flow between 15 and 25 cm H2O in 10, and pa thologic results (greater than 25 cm H2O) in 8 patients. After percutaneous nephrostomy, the serum creatinine level decreased in 22 of 25 patients, al though the urodynamic pressure flow revealed a significant obstruction (Whi taker test greater than 25 cm H2O) in only 8 patients. The sensitivity of t he Whitaker test to indicate the relevance of post-renal transplant stenosi s in comparison to the declining serum creatinine level after successful pe rcutaneous nephrostomy was 79%; the specificity was 50%, Conclusions, The results of our study indicate that a decreasing creatinine level in correlation with radiologic results is the leading finding in dil ation of transplanted kidneys without rejection. The Whitaker test, as a pr essure flow examination, provided no additional information. UROLOGY 56: 49 -52, 2000, (C) 2000, Elsevier Science Inc.