Long-term Double-J stenting is superior to short-term Single-J stenting in kidney transplantation.
Oudmaijer, C. A. J., et al.PLoS ONE [Electronic Resource] 2025; 20(1): e0317991.
Aims
This study aimed to compare two ureteric stenting strategies to determine the more effective stenting approach.
Interventions
Participants were randomly assigned to either the Single-J stent group or the Double-J stent group.
Participants
300 kidney transplant recipients.
Outcomes
The primary endpoint was percutaneous nephrostomy (PCN) placement during a period of six months following transplantation. The secondary endpoints were incidence of catheter dysfunction, reoperation, graft failure, haematuria, urosepsis, urinary tract infection (UTI), radiologic interventions, tacrolimus toxicity, kidney replacement therapy, rejection and cost-efficiency.
Follow-up
6 months following transplantation
CET Conclusions
This large single-centre RCT compared two strategies for ureteric stenting following renal transplantation. Patients were randomised to internal double-J stent for 3 weeks, or externalised single-J stent for 9 days post-operatively. Primary outcome was requirement for percutaneous nephrostomy within 6 months of transplant and was significantly higher for single-J stent patients (14.5% vs 4.5%). Of note, timing for removal of the single J stent resulted in a significantly longer length of stay, resulting in increased costs for this group. In general, this is a well conducted and reported study, although the nature of the intervention precluded blinding. Overall, it appears that ureteric complications requiring nephrostomy are unacceptably high with a single-J stent strategy, and the delay in discharge and increased intervention rates significantly increase healthcare costs.
Data analysis
Per protocol analysis
Trial registration
CN-01906069; NL7183