Impact of different urinary tract infection phenotypes within the first year post-transplant on renal allograft outcomes.

Details

Serval ID
serval:BIB_AF52B0435C03
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of different urinary tract infection phenotypes within the first year post-transplant on renal allograft outcomes.
Journal
American journal of transplantation
Author(s)
Brune J.E., Dickenmann M., Wehmeier C., Sidler D., Walti L., Golshayan D., Manuel O., Hadaya K., Neofytos D., Schnyder A., Boggian K., Müller T., Schachtner T., Khanna N., Schaub S.
Working group(s)
and the Swiss Transplant Cohort Study
ISSN
1600-6143 (Electronic)
ISSN-L
1600-6135
Publication state
Published
Issued date
07/2022
Peer-reviewed
Oui
Volume
22
Number
7
Pages
1823-1833
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
In this study, we investigated the clinical impact of different urinary tract infection (UTI) phenotypes occurring within the first year after renal transplantation. The population included 2368 transplantations having 2363 UTI events. Patients were categorized into four groups based on their compiled UTI events observed within the first year after transplantation: (i) no colonization or UTI (n = 1404; 59%), (ii) colonization only (n = 353; 15%), (iii) occasional UTI with 1-2 episodes (n = 456; 19%), and (iv) recurrent UTI with ≥3 episodes (n = 155; 7%). One-year mortality and graft loss rate were not different among the four groups, but patients with recurrent UTI had a 7-10 ml/min lower eGFR at year one (44 ml/min vs. 54, 53, and 51 ml/min; p < .001). UTI phenotypes had no impact on long-term patient survival (p = .33). However, patients with recurrent UTI demonstrated a 10% lower long-term death-censored allograft survival (p < .001). Furthermore, recurrent UTI was a strong and independent risk factor for reduced death-censored allograft survival in a multivariable analysis (HR 4.41, 95% CI 2.53-7.68, p < .001). We conclude that colonization and occasional UTI have no impact on pertinent outcomes, but recurrent UTI are associated with lower one-year eGFR and lower long-term death-censored allograft survival. Better strategies to prevent and treat recurrent UTI are needed.
Keywords
Allografts, Graft Survival, Humans, Kidney Transplantation/adverse effects, Phenotype, Retrospective Studies, Risk Factors, Urinary Tract Infections/epidemiology, Urinary Tract Infections/etiology, allograft loss, patient survival, renal transplantation, urinary tract infection
Pubmed
Web of science
Open Access
Yes
Create date
21/03/2022 9:58
Last modification date
04/08/2022 6:38
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