Percutaneous Nephrostomy in Kidney Transplant Recipients: Incidence, Risk Factors, Complications and Outcomes

Ureteral stenosis is a frequent complication after kidney transplantation, causing significant morbidity and potential graft function impairment. Treatment options include conservative management, endourological procedures, surgical interventions and percutaneous nephrostomy (PCN). While PCN effectively relieves obstruction, it comes with its own complications. This study evaluates the risk factors, incidence, complications and outcomes of PCN in this population. We conducted a retrospective case series analysis of 98 kidney transplant recipients who underwent PCN. Data on demographics, clinical characteristics and procedural outcomes were collected and analysed to assess the incidence of complications and identify associated risk factors. Among the 98 recipients, the median age at transplant was 56 years, with 52% being male. The most common comorbidities included hypertension (75.5%) and diabetes mellitus (35.7%). Complications occurred in 38.8% of patients, with infections being the most frequent (74.4%), including urinary tract infections (28.9%) and pyelonephritis (22.4%). The primary organisms identified were gram-negative bacteria (55.1%). Reconstructive surgery was required in 35.7% of cases and patient survival was 83.7% at follow-up. In conclusion, PCN in kidney transplant recipients is associated with a high rate of complications, particularly infections. Effective management necessitates the identification and addressing of associated risk factors such as diabetes, elevated BMI and specific induction therapies. While PCN is vital for preserving graft function, further research should focus on refining clinical protocols and developing targeted preventive strategies for high-risk patients.