Predictive factors and management of urinary tract infections after kidney transplantation: a retrospective cohort study
- PMID: 33030613
- DOI: 10.1007/s10157-020-01974-w
Predictive factors and management of urinary tract infections after kidney transplantation: a retrospective cohort study
Abstract
Background: Urinary tract infection (UTI) is one of the most common infectious complications in kidney transplant recipients. The aims of our study were to identify possible predictive factors for UTI and advocate for the management of UTI after kidney transplantation (KT).
Methods: Between January 2013 and December 2018, 182 adult patients with end-stage kidney disease who underwent KT were retrospectively analyzed. Patients who had urinary symptoms and positive urine culture were diagnosed with UTI. The types of urinary bacteria causing UTIs were also examined.
Results: UTIs occurred in forty-one patients (25.1%), and the median time to UTI onset (UTI-free survival) after KT was 189 days. The Cox hazard regression analysis showed that the predictive factors for UTI onset were as follows: posttransplant urinary catheterization, including indwelling urinary catheterization and clean intermittent catheterization; a maximum bladder capacity before KT of less than 150 ml; and a low serum albumin level at 1 month after KT. The most common causative agent was Escherichia coli (56.6%), followed by Enterococcus spp. (15.6%) and Klebsiella spp.
Conclusions: Kidney transplant recipients with prolonged postoperative malnutrition, posttransplant voiding dysfunction and/or urinary storage disorder had an increased risk of UTI. Bladder function tests, such as uroflowmetry, postvoid residual urine tests, and urodynamic tests, were needed to predict UTI. For patients with malnutrition, care should be taken to ensure sufficient calorie intake. Kidney transplant recipients who develop UTI should be treated as complicated UTI patients.
Keywords: Bladder function tests; Kidney transplantation; Malnutrition; Predictive factor; Urinary tract infections.
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References
-
- Rosselli D, Rueda JD, Diaz CE. Cost-effectiveness of kidney transplantation compared with chronic dialysis in end-stage renal disease. Saudi J Kidney Dis Transpl. 2015;26(4):733–8. - DOI
-
- Chuang P, Parikh CR, Langone A. Urinary tract infections after renal transplantation: a retrospective review at two US transplant centers. Clin Transplant. 2005;19:230–5. - DOI
-
- Pelle G, Vimont S, Levy PP, et al. Acute graft pyelonephritis representing risk factor imparing long-term kidney graft function. Am J Transplant. 2007;7:899–907. - DOI
-
- Wu X, Dong Y, Liu Y, et al. The prevalence and predictive factors of urinary tract infection in patients undergoing renal transplantation: a meta-analysis. Am J Infect Control. 2016;44:1261–8. - DOI
-
- Rutkowski B, et al. Urinary tract infections during the first year after renal transplantation: one center’s experience and a review of the literature. Clin Transplant. 2014;28:1263–70. - DOI
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