Risk factors and outcomes of urinary tract infections after pediatric renal transplant
Kaan Gulleroglu1, Esra Baskin1, Aysun C. Yilmaz1, Mahir Kirnap2, Gokhan Moray2, Mehmet A. Haberal2.
1Pediatric Nephrology, Baskent University, Ankara, Turkey; 2Transplantation, Baskent University, Ankara, Turkey
Introduction: Recurrent urinary tract infections are a common and important problem after renal transplant.We evaluate risk factors and outcomes of urinary tract infections after pediatric renal transplant.
Method: We retrospectively evaluated the data files from 165 pediatric renal transplant patients. Patients with and withouturinary tract infections after renal transplant were divided into 2 groups. Demographics of the patients, graft functions, infections, acute rejection episodes and graft loss were recorded.
Results: One hundred sixty five children (M/F: 92/73) with kidney transplant were enrolled to the study,61 of them had urinary tract infection after renal transplant. Mean age at the time of the transplantation was 12.92±4.73years. Mean follow-up time after transplantation was 6.36±4.45 years.Mean episode of urinary tract infection was 3.60±3.05 episode/patient. Although urinary tract infections rate was significantly higher in patients with lower urinary tract dysfunction, 35% of patient without lower urinary tract dysfunction hadurinary tract infection after renal transplant. Urinary tract infectionriskwas 2.58 times higher for girls when compared with boys.There was any significant differencebetween two groups forimmunosuppressive treatment.GFR values at 3rd(76.10±31.30 ml/min vs. 76.74±30.20 ml/min, p=0.90) and 5th year of follow-up (68.43±33.50 ml/min vs. 59.63±32.15 ml/min, p=0.20) of two groups was similar. There was any significant difference between two groups for rejection episodes. 8 patients (4.84%) were lost their graft during 5 years follow-up. 3 of these patients was also in urinary tract infection group and one of them has lower urinary tract dysfunction
Conclusion: Lower urinary tract dysfunction and female gender are major risk factors for recurrent urinary tract infectionsafter renal transplant. Renal transplant has similar outcomes, with similar GFR levels and acute rejection episode rate in children with and without urinary tract infection. Close monitoring, adequate treatment and appropriate prophylaxis of urinary tract infection will improve outcomes of renal transplant.
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