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Review
. 2024 May 1;34(3):146-153.
doi: 10.1097/MOU.0000000000001163. Epub 2024 Mar 7.

Effect of increasing age and ureteral stent implantation on urinary tract infections after kidney transplantation - update of recent literature

Haris Omic  1 , Michael Eder
Affiliations
Review

Effect of increasing age and ureteral stent implantation on urinary tract infections after kidney transplantation - update of recent literature

Haris Omic et al. Curr Opin Urol. .

Abstract

Purpose of review: This review aims to present the recent literature regarding effects of aging and ureteral stent implantation (UrS) on the risk of urinary tract infections (UTIs) in kidney transplant (KTX) recipients.

Recent findings: UTIs in kidney transplant recipients remain a clinical challenge and represent a leading cause of morbidity, hospitalization rates, and mortality. Higher age was described as a significant risk factor for UTIs in several studies including a recent Brazilian analysis, indicating a 3.6%/years of age increase in UTI risk. Subsequently, a large meta-analysis, published in 2023, confirmed the correlation between older age and elevated UTI risk. The Swiss Transplant Cohort Study in 2022, largest of its kind, similarly confirmed a link between advanced age and heightened risk of recurrent UTIs in KTX. A recent prospective study highlighted UrS placement as a modifiable risk factor, emphasizing the need for careful consideration and antibiotic prophylaxis. Additionally, the type of stents played a crucial role, with external stents associated with a 1.69 times higher UTI risk. The challenge of determining optimal UrS removal timing further complicates posttransplant care, with insufficient evidence to guide practices.

Summary: The aging population of KTX recipients requires a personalized approach to effectively reduce and manage UTIs as one of the most important complications following KTX. Prophylactic stent implantation is successful in lowering ureteral complications, however, is associated with an increased incidence of UTIs. To reduce the increased risk of UTIs, the length of stent insertion requires strict supervision and maintenance.

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Conflict of interest statement

The authors declare that the research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Box 1
Box 1
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FIGURE 1
FIGURE 1
Risk factors for urinary tract infections in kidney transplant recipients [▪▪,51]. IS, immunosuppression; UTI, urinary tract infection.
FIGURE 2
FIGURE 2
Guidance on the recommended scenarios for employing ureteral stents (UrS), outlining both the positive and negative consequences linked to UrS implantations [,,,▪▪,–,▪▪,–41].
See this image and copyright information in PMC

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References

    1. Dreyer GJ, de Fijter JW. Transplanting the elderly: mandatory age- and minimal histocompatibility matching. Front Immunol 2020; 11:359. - PMC - PubMed
    1. Mehta J, Ndubueze O, Tatum D, et al. . Kidney transplant outcomes in recipients over the age of 70. Cureus 2023; 15:e34021. - PMC - PubMed

    2. In this retrospective review of kidney transplant recipients aged ≥70 years, short-term outcomes were favorable, comparable to younger cohorts. However, the decline in graft survival over time was more pronounced in the older age group, potentially attributed to decreased patient survival, highlighting the need for validation in larger multicenter studies.

    1. Halskov ACL, Dagnæs-Hansen J, Stroomberg HV, et al. . Incidence of and risk factors for recurrent urinary tract infections in renal transplant recipients. Eur Urol Open Sci 2023; 52:115–122. - PMC - PubMed

    2. The findings of this study revealed that 21.5% of patients experienced urinary tract nfections, with increasing age, female gender, history of lower urinary tract symptoms, and a UTI within 30 days of surgery being associated with higher risk

    1. Yemini R, Rahamimov R, Ghinea R, Mor E. Long-term results of kidney transplantation in the elderly: comparison between different donor settings. J Clin Med 2021; 10:5308. - PMC - PubMed
    1. Funnell M, Ahmed J. 236.7: Prophylactic ureteric stents in renal transplant recipients; is early removal associated with higher rates of urological complications. A retrospective analysis of a single institution. Transplantation 2022; 106:S110.

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