Febrile urinary tract infection after pediatric kidney transplantation: a multicenter, prospective observational study
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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.
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.
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 %.
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.
KeywordsChildren Kidney transplantation Urinary tract infection CAKUT Outcome
Congenital anomalies of the kidney and urinary tract
Technetium-99m dimercaptosuccinic acid
End-stage renal disease
Estimated glomerular filtration rate
Febrile urinary tract infection
Gesellschaft für Pädiatrische Nephrologie
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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