Nephrogenic metaplasia: long-term haemodialysis and anuria as potential risk factors and reversibility with renal transplantation.

AIM

To determine the incidence of nephrogenic metaplasia in patients with defunctionalized bladders due to long-term end-stage renal failure on haemodialysis.

METHODS

From the dialysis registry of the Princess Alexandra Hospital 13 anuric patients who had been on haemodialysis for 10 or more years were identified. Of these, seven were currently awaiting renal transplantation and six had successful transplants. Endoscopic assessment of their lower urinary tracts was performed.

RESULTS

Three cases of nephrogenic metaplasia were identified. In one case this led to significant haematuria following transplantation. However, the changes of nephrogenic metaplasia disappeared over the subsequent 18 months without specific treatment.

CONCLUSIONS

It appears that a chronically defunctionalized bladder in the presence of end-stage renal failure is associated with an increased risk of nephrogenic metaplasia. These changes may spontaneously regress following transplantation and restoration of bladder function.