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Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Hospitalizations after Renal Transplantation in Children: Risk Factors, Causes, and Outcomes
Songül Yılmaz1, Zeynep Birsin Özçakar2, Nilgün Çakar2
1Department of Pediatrics, Division of Pediatric Nephrology, Ankara University School of Medicine, Ankara, Turkey, songulyilmaz23@gmail.com.
Insights
Pediatric kidney transplant recipients frequently experience hospitalizations, primarily due to infections. Younger age, induction therapy, and congenital anomalies increase hospitalization risk, negatively impacting long-term graft prognosis.
Area of Science:
- Pediatric Nephrology
- Transplantation Medicine
- Clinical Pediatrics
Background:
- Hospitalizations are common in pediatric kidney transplant recipients.
- Understanding hospitalization causes and risk factors is crucial for improving outcomes.
Purpose of the Study:
- To determine the frequency and causes of post-transplant hospitalizations in children.
- To identify risk factors associated with these hospitalizations.
- To assess the impact of hospitalizations on long-term renal prognosis.
Main Methods:
- Retrospective review of pediatric renal transplant patients followed for at least six months.
- Data collection included age, gender, primary disease, immunosuppression, hospitalization reasons, and graft outcomes.
- Statistical analysis to identify risk factors and correlations.
Main Results:
- 93.2% of 74 children were hospitalized 446 times over a median of 54 months.
- Infections (70%) were the leading cause, followed by non-infectious reasons (29.5%) like graft dysfunction and rejection.
- Younger age, induction therapy, and congenital anomalies of the kidney and urinary tract (CAKUT) were significant risk factors for hospitalization.
- Increased hospitalizations negatively correlated with final glomerular filtration rate.
Conclusions:
- Children with CAKUT, those receiving induction therapy, and younger children face higher hospitalization rates post-transplant.
- Preventive strategies targeting these risk factors are essential for better graft prognosis.
Introduction:
The aims of this study were to evaluate the frequency and causes of hospitalizations in the posttransplant period of children, investigate the risk factors, and evaluate the relationship between hospitalizations and renal prognosis in the long term.
Methods:
We retrospectively reviewed the files of pediatric renal transplant patients, followed at least 6 months after kidney transplantation, in our center. Clinical information including age at transplantation, gender, primary disease, donor type, immuno-suppressive medication, hospitalization dates, and indications (infections and non-infectious) during follow-up period and graft outcomes was recorded.
Results:
A total of 74 children (46 males) were followed up for a median of 54 months. Among them, 69 patients (93.2%) were hospitalized 446 times. The most common cause of hospitalizations was infections (314 times, 70%). Urinary tract infections were the most important cause followed by upper respiratory tract infections. Forty (54%) patients were hospitalized 132 times (29.5%) for non-infectious reasons. The most common non-infectious reason was nonspecific graft dysfunction (19 patients, 30 times), followed by rejection (17 patients, 27 times). Younger age, use of induction therapy, and having congenital anomalies of kidney and urinary tract (CAKUT) were found to be risk factors for increased hospitalization rates (p < 0.05). The number of hospitalizations was found to be negatively affecting the final glomerular filtration rate of transplant recipients (p: 0.04, r: -0.023).
Conclusion:
Patients with CAKUT, who received induction therapy, and small children were hospitalized more frequently after transplantation. Strategies to prevent hospitalizations will achieve a better graft prognosis.
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