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Causes of frequency and nocturia after renal transplantation

  1. Marian J.A. Van der Weide1,
  2. Theo Van Achterberg1,
  3. Jeroen P.J.M. Smits3,
  4. John P.F.A. Heesakkers1,
  5. Bart L.H. Bemelmans4,
  6. Lukas B. Hilbrands2

Article first published online: 19 MAR 2008

DOI: 10.1111/j.1464-410X.2007.07292.x

Issue

BJU International

BJU International

Volume 101, Issue 8, pages 1029–1034, April 2008

Additional Information

How to Cite

Van der Weide, M. J., Van Achterberg, T., Smits, J. P., Heesakkers, J. P., Bemelmans, B. L. and Hilbrands, L. B. (2008), Causes of frequency and nocturia after renal transplantation. BJU International, 101: 1029–1034. doi: 10.1111/j.1464-410X.2007.07292.x

Author Information

  1. 1

    Department of Urology, Center for Quality of Care Research, Nursing Science Section, and

  2. 2

    Department of Nephrology, Radboud University Nijmegen Medical Centre,

  3. 3

    Department of Economics, Radboud University Nijmegen, and

  4. 4

    Department of Urology, Free University Medical Center, Amsterdam, the Netherlands

*Marian Van der Weide, Internal postal code 659, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, the Netherlands. e-mail: M.vanderweide@csscb.umcn.nl

Publication History

  1. Issue published online: 19 MAR 2008
  2. Article first published online: 19 MAR 2008
  3. Accepted for publication 3 August 2007

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Keywords:

  • kidney;
  • transplantation;
  • frequency;
  • nocturia;
  • SEM analysis

OBJECTIVE

To explore the role of bladder capacity, bladder pain, dysfunctional voiding, urgency, urinary tract infections (UTIs), and urinary output as potential causes of frequency and nocturia after renal transplantation.

PATIENTS AND METHODS

Data were gathered from 52 adult renal transplant patients (35 men and 17 women, mean age 49 years), using a written questionnaire, medical records, frequency/volume charts, and urinary cultures. The mean time between transplantation and data collection was 5 months. Structural equation modelling (SEM) was used for the simultaneous assessment of direct and indirect relationships between explanatory variables and voiding frequency.

RESULTS

Frequency and nocturia were found in 54% and 60% of the study population, respectively. Frequency was directly associated with a small bladder capacity, bladder pain, urgency, and a high daytime urine volume, and indirectly by UTIs (via urgency and bladder pain). Nocturia was associated with high nocturnal urine volume, small bladder capacity and dysfunctional voiding. A quarter of the patients had small bladders and another quarter had large bladders, the latter being associated with nocturnal polyuria.

CONCLUSIONS

The presence of frequency, especially when accompanied by bladder pain, might aid the physician to identify patients with small bladders. The presence of nocturia can be the result of a high nocturnal urine volume, which increases the risk of bladder enlargement. Because both abnormal bladder conditions can contribute to graft dysfunction, we recommend a urological follow-up after renal transplantation, using frequency/volume charts.

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