The effect of nurse-led bladder training on urinary tract outcomes after kidney transplantation.

INTRODUCTION: Optimal bladder function is crucial for kidney transplant success. Bladder training could help prevent dysfunction and complications, yet evidence-based guidelines for bladder training methods are limited. This study evaluates two protocols: standard hourly training versus tailored to preoperative urine output, assessing urinary tract outcomes. METHODS: This pre-post study used data from the TransplantLines data and biobank on kidney transplant patients admitted in 2019 (standard bladder training) and 2022 (new protocol) to a Dutch academic hospital. Standard bladder training involved hourly urination with regular post-void residual checks, whereas the new protocol adjusted urination frequency and scan schedules based on preoperative urine output. Logistic regression analyses were performed to evaluate the following outcomes: residual urine volume > 100ml, urinary tract infection or re-catheterization within three months post-transplantation. RESULTS: The analysis included 211 patients (70% male, mean age 55, n=100 standard protocol, n=111 new protocol). Multivariate analysis showed no differences between the protocols in the investigated outcomes. A significant interaction between protocol and age on re-catheterization was found suggesting higher re-catheterization risk in older patients under the new protocol. DISCUSSION: The revised protocol might promote patient well-being and simultaneously improve nurse working conditions.