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Pyelonephritis and vesicoureteral reflux after renal transplantation in young children
T J Neuhaus1, M Schwöbel, R Schlumpf
1University Children's Hospital, Zürich, Switzerland.
Insights
Pyelonephritis in children post-renal transplant is linked to vesicoureteral reflux and young age. Early intervention for reflux can prevent infection and preserve graft function.
Area of Science:
- Pediatric Nephrology
- Transplantation Immunology
- Urology
Background:
- Pyelonephritis poses a significant risk to renal allograft function in pediatric transplant recipients.
- Identifying risk factors is crucial for optimizing post-transplant care and outcomes.
Purpose of the Study:
- To evaluate the morbidity and identify risk factors associated with pyelonephritis in children following renal transplantation.
Main Methods:
- A retrospective analysis of 41 pediatric renal transplant recipients between 1986 and 1995.
- Detailed evaluation of children with documented pyelonephritis post-transplantation.
Main Results:
- Six children transplanted before age 7 experienced 1-3 pyelonephritis episodes, significant renal dysfunction, and vesicoureteral reflux into the graft.
- Antireflux reimplantation in 5 children corrected reflux; 3 had temporary obstruction. No further infections occurred post-correction.
- All patients maintained functioning grafts after a median follow-up of 4.5 years.
Conclusions:
- Vesicoureteral reflux and young recipient age (<7 years) are identified as major risk factors for pyelonephritis after pediatric renal transplantation.
- Correction of vesicoureteral reflux is essential for preventing recurrent infections and subsequent graft dysfunction.
Purpose:
We assessed morbidity and risk factors of pyelonephritis in children after renal transplantation.
Materials And Methods:
Between 1986 and 1995, 41 children underwent transplantation and all who had documented pyelonephritis were evaluated.
Results:
Six children who underwent transplantation before age 7 years had 1 to 3 episodes of pyelonephritis with significant renal dysfunction and vesicoureteral reflux into the grafted system. An antireflux reimplantation procedure in 5 children was complicated by temporary functional obstruction in 3. No further infection occurred after correction of vesicoureteral reflux. After a median of 4.5 years post-transplantation all patients have a functioning graft.
Conclusions:
After renal transplantation vesicoureteral reflux and young recipient age are major risk factors for pyelonephritis with subsequent graft dysfunction.