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[Urinary infections in patients with urologic complications after kidney transplantation]
L Lyerová1, O Schück, J Skibová
1Klinika nefrologie a Transplantcentrum IKEM, Praha. ladislava.noskova@medicon.cz
Background:
Urinary tract infections (UTI) are the most frequent infectious complications after renal transplantation (Tx). We tried to analyse whether the urinary tract infection was one of the factors which participated in the lower allograft survival rates and in the reduced allograft function in urologically complicated (UC) patients.
Methods And Results:
We observed 77 patients after Tx whom 42 had urinary fistula, 32 had urinary tract dilatation a 3 suffered from both complications. They were observed from January 1992 through December 1999. 100 patients without urological complications represented a control group (N). Obtained data was statistically evaluated using t-test, chi 2-test, correlation analysis. Graft and patient survival rates were assessed using the Kaplan-Meier method. We have found that UC patients after Tx had worse renal function compared with patients not suffering from this complications. Using Kaplan-Meier methods we have found that graft survival rate in patients with UC is significantly lower than that in the control group (5-year graft survival 0.6 vs 0.82, p < 0.01). On the other hand there were no differences in the 5-year patients survival rate between the followed groups of patients (0.74 vs 0.83). There was no significant correlation between predicted creatinine clearance and followed indicators of UTI--total time of positive urine bacterial cultivation, number of infectious periods and total time of antibiotic therapy. There were no significant differences in graft survival during 5 years between patients with UTI and control group.
Conclusions:
Our results suggest that patients with UC are at increased risk of urinary tract infection. Our findings are in keeping with the assumption that UTI in patients with UC do not significantly participate in the decreased level of graft function and in the shorter graft survival rates.
Insights
Urologically complicated patients after renal transplantation face higher risks of urinary tract infections (UTI). However, these UTIs do not significantly impact graft function or survival rates in this patient group.
Area of Science:
- Nephrology
- Urology
- Infectious Diseases
Context:
- Urinary tract infections (UTI) are common post-renal transplant complications.
- Urologically complicated (UC) patients represent a specific subgroup at higher risk.
- Assessing the impact of UTI on graft outcomes in UC patients is crucial.
Purpose:
- To investigate the role of urinary tract infections (UTI) in graft survival and function among urologically complicated (UC) renal transplant recipients.
- To compare graft and patient survival rates between UC patients with and without UTI.
Summary:
- This study observed 77 urologically complicated (UC) renal transplant patients and 100 controls. UC patients exhibited poorer renal function and significantly lower 5-year graft survival (0.6 vs. 0.82).
- Despite increased UTI risk in UC patients, no significant correlation was found between UTI indicators and graft function or survival.
- Patient survival rates were similar between groups (5-year: 0.74 vs. 0.83).
Impact:
- Findings suggest that while UC patients are prone to UTIs, these infections may not be the primary driver of reduced graft function or survival.
- Highlights the importance of managing urological complications in renal transplant recipients.
- Informs clinical practice regarding the specific contribution of UTIs to post-transplant outcomes in this vulnerable population.