Acute pyelonephritis represents a risk factor impairing long-term kidney graft function

Autor: Gaëlle Pellé, Nacera Ouali, Alain Vandewalle, Guillaume Arlet, Sophie Vimont, Alexandre Hertig, Pierre Levy, Eric Rondeau, Cécilia Chassin
Přispěvatelé: Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de réanimation, Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Pellé G, Vimont S, Levy PP, Hertig A, Ouali N, Chassin C, Arlet G, Rondeau E, Vandewalle A., Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)
Jazyk: angličtina
Rok vydání: 2007
Předmět:
Male
Time Factors
MESH: Treatment Failure
030232 urology & nephrology
MESH: Urinary Tract Infections
030230 surgery
urologic and male genital diseases
Gastroenterology
MESH: Kidney Transplantation
chemistry.chemical_compound
Postoperative Complications
0302 clinical medicine
MESH: Postoperative Complications
Immunology and Allergy
Pharmacology (medical)
Cumulative incidence
Treatment Failure
Kidney transplantation
MESH: Treatment Outcome
Kidney
MESH: Middle Aged
Pyelonephritis
Graft Survival
MESH: Follow-Up Studies
Middle Aged
female genital diseases and pregnancy complications
3. Good health
Treatment Outcome
medicine.anatomical_structure
Creatinine
MESH: Survival Analysis
Acute Disease
Urinary Tract Infections
MESH: Acute Disease
Female
hormones
hormone substitutes
and hormone antagonists
Adult
medicine.medical_specialty
animal structures
MESH: Graft Survival
MESH: Pyelonephritis
Urinary system
Renal function
MESH: Creatinine
03 medical and health sciences
Internal medicine
medicine
Humans
Retrospective Studies
Transplantation
MESH: Humans
business.industry
MESH: Time Factors
MESH: Adult
MESH: Retrospective Studies
medicine.disease
Kidney Transplantation
Survival Analysis
MESH: Male
Surgery
chemistry
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
MESH: Female
Follow-Up Studies
Kidney disease
Zdroj: American Journal of Transplantation
American Journal of Transplantation, 2007, 7 (4), pp.899-907. ⟨10.1111/j.1600-6143.2006.01700.x⟩
American Journal of Transplantation, Wiley, 2007, 7 (4), pp.899-907. ⟨10.1111/j.1600-6143.2006.01700.x⟩
ISSN: 1600-6135
1600-6143
DOI: 10.1111/j.1600-6143.2006.01700.x⟩
Popis: International audience; Urinary tract infections (UTIs) and acute pyelonephritis (APN) often occur after renal transplantation, but their impact on graft outcome is unclear. One hundred and seventy-seven consecutive renal transplantations were investigated to evaluate the impact of UTIs and APN on graft function. The cumulative incidence of UTIs was 75.1% and that of APN was 18.7%. UTIs occurred mainly during the first year after transplantation and Escherichia coli, Pseudomonas aeruginosa and Enteroccocus sp. were the most frequent pathogens identified. The risk of developing APN was higher in female (64%) than in male recipients, and was correlated with the frequency of recurrent UTIs (p < 0.0001) and rejection episodes (p = 0.0003). APN did not alter graft or recipient survival, however, compared to patients with uncomplicated UTIs, patients with APN exhibited both a significant increase in serum creatinine and a decrease in creatinine clearance, already detected after 1 year (aMDRD-GFR: APN: 39.5 +/- 12.5; uncomplicated UTI: 54.6 +/- 21.7 mL/min/1.73 m(2), p < 0.01) and still persistent ( approximately - 50%) 4 years after transplantation. Multivariate analysis revealed that APN represents an independent risk factor associated with the decline of renal function (p = 0.034). Therefore, APN may be associated with an enduring decrease in renal graft function.
Databáze: OpenAIRE
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