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Pediatric Nephrology

, Volume 31, Issue 6, pp 1021–1028 | Cite as

Febrile urinary tract infection after pediatric kidney transplantation: a multicenter, prospective observational study

  • Friederike WeigelEmail author
  • Anja Lemke
  • Burkhard Tönshoff
  • Lars Pape
  • Henry Fehrenbach
  • Michael Henn
  • Bernd Hoppe
  • Therese Jungraithmayr
  • Martin Konrad
  • Guido Laube
  • Martin Pohl
  • Tomáš Seeman
  • Hagen Staude
  • Markus J. Kemper
  • Ulrike John
Original Article

Abstract

Background

Febrile urinary tract infections (fUTIs) are common after kidney transplantation (KTx); however, prospective data in a multicenter pediatric cohort are lacking. We designed a prospective registry to record data on fUTI before and after pediatric KTx.

Methods

Ninety-eight children (58 boys and 40 girls) ≤ 18 years from 14 mid-European centers received a kidney transplant and completed a 2-year follow-up.

Results

Posttransplant, 38.7 % of patients had at least one fUTI compared with 21.4 % before KTx (p = 0.002). Before KTx, fUTI was more frequent in patients with congenital anomalies of kidneys and urinary tract (CAKUT) vs. patients without (38 % vs. 12 %; p = 0.005). After KTx, fUTI were equally frequent in both groups (48.7 % vs. 32.2 %; p = 0.14). First fUTI posttransplant occurred earlier in boys compared with girls: median range 4 vs. 13.5 years (p = 0.002). Graft function worsened (p < 0.001) during fUTI, but no difference was recorded after 2 years. At least one recurrence of fUTI was encountered in 58 %.

Conclusion

This prospective study confirms a high incidence of fUTI after pediatric KTx, which is not restricted to patients with CAKUT; fUTIs have a negative impact on graft function during the infectious episode but not on 2-year graft outcome.

Keywords

Children Kidney transplantation Urinary tract infection CAKUT Outcome 

Abbreviations

AR

Acute rejection

CAKUT

Congenital anomalies of the kidney and urinary tract

CRP

C-reactive protein

DMSA

Technetium-99m dimercaptosuccinic acid

ESRD

End-stage renal disease

eGFR

Estimated glomerular filtration rate

fUTI

Febrile urinary tract infection

GPN

Gesellschaft für Pädiatrische Nephrologie

KTx

Kidney transplantation

SCr

Serum creatinine

VUR

Vesicoureteral reflux

VCUG

Voiding cystourethrography

Notes

Acknowledgments

This study was supported by the German Society of Pediatric Nephrology (GPN).

Compliance with ethical standards

The study was conducted according to the principles of the Declaration of Helsinki and was approved by the Ethics Committee of the Friedrich-Schiller-University Jena and the respective Ethics Committees of each contributing center. All patients were enrolled at time of listing for Eurotransplant after parental informed consent.

Conflict of interests

The authors declare there are no conflicts.

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Copyright information

© IPNA 2016

Authors and Affiliations

  • Friederike Weigel
    • 1
    Email author
  • Anja Lemke
    • 2
  • Burkhard Tönshoff
    • 3
  • Lars Pape
    • 4
  • Henry Fehrenbach
    • 5
  • Michael Henn
    • 6
  • Bernd Hoppe
    • 7
  • Therese Jungraithmayr
    • 8
  • Martin Konrad
    • 9
  • Guido Laube
    • 10
  • Martin Pohl
    • 11
  • Tomáš Seeman
    • 12
  • Hagen Staude
    • 13
  • Markus J. Kemper
    • 2
  • Ulrike John
    • 1
  1. 1.Pediatric NephrologyUniversity Medical Center JenaJenaGermany
  2. 2.Pediatric NephrologyUniversity Childrens Hospital, University Medical Center Hamburg EppendorfHamburgGermany
  3. 3.Department of Pediatrics IUniversity Children’s HospitalHeidelbergGermany
  4. 4.Pediatric NephrologyHannover Medical SchoolHannoverGermany
  5. 5.Children’s Hospital MemmingenMemmingenGermany
  6. 6.Pediatric Nephrology, Children’s Hospital St. GeorgLeipzigGermany
  7. 7.Pediatric NephrologyUniversity Medical Center BonnBonnGermany
  8. 8.Department of Pediatrics IUniversity Medical Center InnsbruckInnsbruckAustria
  9. 9.Pediatric NephrologyUniversity Medical Center MünsterMünsterGermany
  10. 10.Department of NephrologyUniversity Children’s HospitalZurichSwitzerland
  11. 11.Pediatric NephrologyUniversity Children’s HospitalFreiburgGermany
  12. 12.2nd School of MedicineUniversity Hospital Motol, Charles University PraguePragueCzech Republic
  13. 13.Pediatric NephrologyUniversity Children’s HospitalRostockGermany

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