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Updated: Jan 29, 2026
Murine Renal Transplantation Procedure
Published on: July 10, 2009
Effects of Clean Intermittent Catheterization on Adherence in Pediatric Renal Transplant Patients
Sarah Ashley1, Arun Chandnani2, Carter Sevick3
1University of Colorado School of Medicine, Aurora, Colorado, USA.
Insights
Pediatric kidney transplant candidates requiring clean intermittent catheterization (CIC) showed lower treatment adherence. Older age also increased non-adherence risk, highlighting the need for early interventions in these vulnerable patients.
Area of Science:
- Nephrology
- Transplant Surgery
- Pediatric Medicine
Background:
- Treatment adherence is critical for successful kidney transplant outcomes.
- The impact of clean intermittent catheterization (CIC) on adherence in pediatric transplant candidates is not well understood.
Purpose of the Study:
- To investigate the association between medical diagnostic factors and treatment adherence in pediatric kidney transplant candidates.
- To evaluate the role of CIC and patient age in predicting adherence using the Pediatric Transplant Rating Instrument (P-TRI).
Main Methods:
- A retrospective chart review of 180 pediatric kidney transplant candidates was conducted.
- Data included demographics, diagnosis, catheterization status, and age.
- Adherence was assessed using a P-TRI subscale, with cumulative logistic regression analyzing differences.
Main Results:
- Patients using CIC pre-transplant had significantly lower adherence scores (OR 0.46, p=0.021).
- Older age correlated with decreased adherence (Spearman correlation -0.25, p<0.001).
Conclusions:
- Pre-kidney transplant CIC use is a risk factor for lower patient adherence.
- Older pediatric patients are also at higher risk for non-adherence.
- Identifying these risk factors allows for targeted interventions to optimize adherence in transplant candidates.
Introduction:
Treatment adherence is essential for successful outcomes post-kidney transplant. Little is known regarding how clean intermittent catheterization (CIC) impacts risk for non-adherence in pediatric solid organ transplant candidates.
Objective:
Evaluate the relationship between medical diagnostic factors and treatment adherence as indicated by the Pediatric Transplant Rating Instrument (P-TRI).
Methods:
Retrospective chart review of 180 pediatric kidney transplant candidates. Patient demographics, diagnosis, catheterization status, and age were assessed. An adherence subscale based on the P-TRI evaluation was used to evaluate patient adherence, and differences in adherence were calculated using cumulative logistic regression.
Results:
Patients who performed CIC prior to kidney transplant had lower adherence scores on the P-TRI compared to those who did not catheterize (OR 0.46, 95% CI: 0.23-0.89, p = 0.021). Age was also correlated with lower adherence scores (Spearman correlation -0.25, p < 0.001) indicating that older patients were at higher risk of non-adherence.
Discussion:
This study differs from existing literature as it explores the relationship between bladder catheterization requirement and patient adherence in kidney transplant candidates. Kidney transplant recipients that perform CIC were found to be at higher risk of non-adherence and should be accommodated for in the clinical setting. These data also support existing literature that identifies the increased risk for non-adherence in adolescent transplant candidates. By identifying adherence risk factors, early interventions can be applied to help optimize adherence.
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