Acute Graft Pyelonephritis Occurring up to 30 Days After Kidney Transplantation: Epidemiology, Risk Factors, and Survival.

Autor: Kroth LV; Programa de Pós-graduação em Medicina e Ciências da Saúde, FAMED/IPB/HSL, Pontifícia Universidade Católica do Rio Grande do Sul (Nefrologia), Porto Alegre, Brazil. Electronic address: leonardo.kroth@pucrs.br., Barreiro FF; Programa de Pós-graduação em Medicina e Ciências da Saúde, FAMED/IPB/HSL, Pontifícia Universidade Católica do Rio Grande do Sul (Nefrologia), Porto Alegre, Brazil., Saitovitch D; Programa de Pós-graduação em Medicina e Ciências da Saúde, FAMED/IPB/HSL, Pontifícia Universidade Católica do Rio Grande do Sul (Nefrologia), Porto Alegre, Brazil., Traesel MA; Programa de Pós-graduação em Medicina e Ciências da Saúde, FAMED/IPB/HSL, Pontifícia Universidade Católica do Rio Grande do Sul (Nefrologia), Porto Alegre, Brazil., d'Avila DO; Programa de Pós-graduação em Medicina e Ciências da Saúde, FAMED/IPB/HSL, Pontifícia Universidade Católica do Rio Grande do Sul (Nefrologia), Porto Alegre, Brazil., Poli-de-Figueiredo CE; Programa de Pós-graduação em Medicina e Ciências da Saúde, FAMED/IPB/HSL, Pontifícia Universidade Católica do Rio Grande do Sul (Nefrologia), Porto Alegre, Brazil.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2016 Sep; Vol. 48 (7), pp. 2298-2300.
DOI: 10.1016/j.transproceed.2016.06.016
Abstrakt: Acute graft pyelonephritis is a very common infection in renal transplantation. The impact of acute graft pyelonephritis (AGPN) on graft and patient outcome has not yet been established. Eight hundred seventy kidney and kidney-pancreas transplants were retrospectively studied, over last 13 years, to verify occurrence of AGPN in the first 30 days post-transplantation. We found that 112 patients (15.8%) presented post-transplantatiom AGPN up to 30 days after a kidney transplantation. The occurrence was higher in older patients (P = .005) and in those with ureteral stents (P = .06). Escherichia coli was the most frequent microorganism in urine cultures (32%). Ureteral stent (relative risk = 1.7; confidence interval [CI], 1.1-2.5; P = .018) was a major risk factor for AGPN as well as older ages (RR = 1.02; CI 1.01-1.04; P = .001), length of hospitalization stay (RR = 1.01; CI, 1.01-1.02; P < .001), and anti-thymocyte globulin (ATG) induction (RR = 1.6; CI, 1.022-2.561; P = .04). Long-term graft and patient survival was significantly lower in patients with pyelonephritis in the first 30 days after transplantation (OR 1.43; 95% CI, 0.95-2.16; P = .024 and OR 1.77; 95% CI, 1.12-2.80; P = .006, respectively). Acute pyelonephritis in the first 30 days after transplantation is therefore associated with a lower long-term graft and patient survival.
(Copyright © 2016 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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