COMPLICATIONS - INFECTIONS

M. Papasotiriou, E. Savvidaki, E. Papachristou, P. Kalliakmani, M. Marangos, E. Fokaeus, D. Karavias, D. Goumenos
Nephrology, Patras University Hospital, Patras/GREECE

Body: Introduction Urinary tract infections (UTIs) are the most frequent cause of bacterial infection in patients after kidney transplantation. The purpose of this study was to record and evaluate urinary tract infections in patients who have undergone kidney transplantation. Methods We studied 122 patients (75 men and 47 women) mean age 44 years. UTIs were recorded retrospectively during the first month, the first year after transplantation and during the entire period of monitoring. Hospital admissions due to these infections were recorded as well. Diabetes mellitus, delayed graft function, acute rejection episodes and the presence of urinary tract obstruction were evaluated as potential risk factors for urinary tract infections. Renal function was assessed by the MDRD6 equation. Results
A total of 316 UTIs were recorded in 74 of 122 patients (60.7%). The most common cause was E. Coli which was isolated in 162 cases. Of the 74 patients, 39 (53%) had one to three episodes of UTIs and 35 (47%) more than three. Of the patients who developed infection in the first month, 77% showed a new episode in the first year and 62% in the next year after transplantation. Of the 316 recorded UTIs 141 (45%) needed hospital treatment while 87 (28%) were hospital-acquired. A strong correlation between female gender and the incidence of UTIs was found throughout the monitoring period (χ²=15,757, p = 0,01). The presence of renal pelvis dilation was also related to the occurrence of UTIs only during the first year after transplantation (χ²=11,248, p = 0,001). Patients’ age, diabetes mellitus, delayed graft function and acute rejection episodes did not correlate with the incidence of UTIs. Long-term renal graft function did not appear to be affected by the emergence of UTIs. Conclusion Patients who have undergone kidney transplantation and present with UTIs often relapse and require hospitalization. Close monitoring and early treatment of renal tract obstruction can reduce the incidence of UTIs after transplantation.

Disclosure: All authors have declared no conflicts of interest.