Double J stenting versus non-stenting in pediatric kidney transplantation: a retrospective single-center comparative...

Kidney transplantation (KT) is the treatment of choice for children with end-stage kidney disease. Double J stenting (DJS) has been proposed to reduce the risk of major urologic complications. However, its efficacy remains conflicting, with existing evidence limited. We aimed to evaluate the incidence of urologic and vascular complications, graft loss, and creatinine clearance in pediatric patients undergoing KT with DJS versus those without DJS.

We retrospectively reviewed all pediatric patients who received KT at our institution (January 2010-December 2021). The baseline demographics, urologic and vascular complications, graft loss, and creatinine clearance at the 1-year follow-up were collected and compared between the DJS and non-DJS groups. Indications for DJS placement included the presence of unresolved uropathies posing a persistent risk to the urinary tract, anuric patients, and cases involving uretero-ureteral anastomosis.

Overall, 156 KT were identified: 84 underwent KT with DJS placement, while 72 did not receive a stent. The incidence of urologic complications was higher in the DJS group than in the non-DJS group (20.8% vs 9.5%, p = 0.07), though this difference was not statistically significant. Vascular and overall complications were similar between groups. At the 1-year follow-up, graft loss and median creatinine clearance were comparable between DJS and non-DJS patients.

DJS in pediatric KT does not appear to decrease the risk of urologic complications, with graft survival and creatinine clearance at one-year follow-up being similar between non-DJS and DJS patients. Selected high-risk children might benefit more from DJS placement.