Bedside diagnosis of lymphorrhea after kidney transplantation surgery: A clinical study

The aim of our study is to evaluate the role of pyridium (phenazopyridine) in the early bedside differential diagnosis of urine leak and lymphorrhea. Twenty-five kidney recipients (15 males and ten females, aged between 14 and 62 years) with persisting post-operative fluid drainage from the drain for more than two weeks were enrolled in this study. Creatinine and urea of three samples, namely serum, urine and the drain fluid, were measured. A single dose of 300 mg of pyridium (phenazopyridine) was then administered to all patients. One physician and one nurse who were unaware of the aim of the study checked and evaluated the color of the samples of urine and drain fluid of each patient. In seven patients, the level of creatinine in the urine and drain fluid was similar and in them the color of both samples became orange to red, indicating urine leak from the ureteric anstomotic site. The remainder of the 18 patients did not show any changes in the drain fluid color and the level of creatinine was nearly same in the serum and drain fluid. In a kidney transplant recipient, pyridium can be used as an easy, safe and easily available indicator for diagnosing urine leak in the drain fluid.