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Recurrent urinary tract infections in kidney transplant recipients during the first-year influence long-term graft function: a single-center retrospective cohort study

  • Francesco Pesce
  • Marida Martino
  • Marco Fiorentino
  • Tiziana Rollo
  • Simona Simone
  • Pasquale Gallo
  • Giovanni Stallone
  • Giuseppe Grandaliano
  • Antonio Schena
  • Marcella Margiotta
  • Donata Mininni
  • Rita Palieri
  • Giuseppe Lucarelli
  • Michele Battaglia
  • Loreto Gesualdo
  • Giuseppe CastellanoEmail author
Original Article
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Abstract

Urinary tract infections (UTIs) after kidney transplantation are associated with significant morbidity. However, data on the impact of UTI on graft survival are controversial. We conducted a retrospective cohort study of 380 kidney transplant patients. Recipients with symptomatic UTIs during the first year after transplantation were categorized into three groups: early (< 3 episodes from months 1st to 6th), late (< 3 episodes during months 7th to 12th) and recurrent (≥ 3 episodes throughout the whole first year). Graft function at three years was considered the primary outcome. Symptomatic UTIs occurred in 184 (48.4%) kidney transplant recipients during the first year; 83 (21.8%) patients developed early UTIs, 50 (13.2%) late UTIs and 51 (13.4%) recurrent UTIs. We observed a significant improvement in graft function after three years in all patients (P < 0.001) except those who had recurrent UTIs. A Kaplan–Meier analysis showed that recipients with recurrent UTIs had worse graft outcome (eGFR value < 60 mL/min/1.73 m2) (P = 0.01). Recurrent UTIs was an independent predictor of graft function at three years in a model adjusted for DGF and episodes of acute rejection (Hazard Ratio, 2.2; 95% CI, 1.3 to 3.5; P = 0.001). Recurrent symptomatic UTIs during the first year after transplantation have negative impact on long-term graft function.

Keywords

Kidney transplant Graft function Urinary tract infections 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Italian Society of Nephrology 2019

Authors and Affiliations

  • Francesco Pesce
    • 1
  • Marida Martino
    • 1
  • Marco Fiorentino
    • 1
    • 2
  • Tiziana Rollo
    • 1
  • Simona Simone
    • 1
  • Pasquale Gallo
    • 1
  • Giovanni Stallone
    • 3
  • Giuseppe Grandaliano
    • 3
  • Antonio Schena
    • 1
  • Marcella Margiotta
    • 4
  • Donata Mininni
    • 4
  • Rita Palieri
    • 1
  • Giuseppe Lucarelli
    • 1
  • Michele Battaglia
    • 1
  • Loreto Gesualdo
    • 1
  • Giuseppe Castellano
    • 1
    • 5
    Email author
  1. 1.Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation UnitUniversity of BariBariItaly
  2. 2.Department of Critical Care Medicine, Center for Critical Care NephrologyCRISMA (Clinical Research, Investigation, and Systems Modeling of Acute Illness) Center, University of Pittsburgh School of MedicinePittsburghUSA
  3. 3.Nephrology Dialysis and Transplantation Unit, Department of Medical and Surgical SciencesUniversity of FoggiaFoggiaItaly
  4. 4.Tissue Typing and Immunology of Transplants Unit, Department of Diagnostic PathologyUniversity of BariBariItaly
  5. 5.Center for Diagnosis and Treatment of Hereditary AngioedemaBariItaly

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