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Recurrent urinary tract infections in kidney transplant recipients during the first-year influence long-term graft function: a single-center retrospective cohort study

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Abstract

Urinary tract infections (UTIs) after kidney transplantation are associated with significant morbidity. However, data on the impact of UTI on graft survival are controversial. We conducted a retrospective cohort study of 380 kidney transplant patients. Recipients with symptomatic UTIs during the first year after transplantation were categorized into three groups: early (< 3 episodes from months 1st to 6th), late (< 3 episodes during months 7th to 12th) and recurrent (≥ 3 episodes throughout the whole first year). Graft function at three years was considered the primary outcome. Symptomatic UTIs occurred in 184 (48.4%) kidney transplant recipients during the first year; 83 (21.8%) patients developed early UTIs, 50 (13.2%) late UTIs and 51 (13.4%) recurrent UTIs. We observed a significant improvement in graft function after three years in all patients (P < 0.001) except those who had recurrent UTIs. A Kaplan–Meier analysis showed that recipients with recurrent UTIs had worse graft outcome (eGFR value < 60 mL/min/1.73 m2) (P = 0.01). Recurrent UTIs was an independent predictor of graft function at three years in a model adjusted for DGF and episodes of acute rejection (Hazard Ratio, 2.2; 95% CI, 1.3 to 3.5; P = 0.001). Recurrent symptomatic UTIs during the first year after transplantation have negative impact on long-term graft function.

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Author notes

  1. Francesco Pesce and Marida Martino equally contributed to the present study.

  2. Loreto Gesualdo and Giuseppe Castellano shared senior authorship.

Authors and Affiliations

  1. Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation Unit, University of Bari, Bari, Italy

    Francesco Pesce, Marida Martino, Marco Fiorentino, Tiziana Rollo, Simona Simone, Pasquale Gallo, Antonio Schena, Rita Palieri, Giuseppe Lucarelli, Michele Battaglia, Loreto Gesualdo & Giuseppe Castellano

  2. Department of Critical Care Medicine, Center for Critical Care Nephrology, CRISMA (Clinical Research, Investigation, and Systems Modeling of Acute Illness) Center, University of Pittsburgh School of Medicine, Pittsburgh, USA

    Marco Fiorentino

  3. Nephrology Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy

    Giovanni Stallone & Giuseppe Grandaliano

  4. Tissue Typing and Immunology of Transplants Unit, Department of Diagnostic Pathology, University of Bari, Bari, Italy

    Marcella Margiotta & Donata Mininni

  5. Center for Diagnosis and Treatment of Hereditary Angioedema, Piazza G. Cesare 11, 70124, Bari, Italy

    Giuseppe Castellano

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  1. Francesco Pesce
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Correspondence to Giuseppe Castellano.

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Pesce, F., Martino, M., Fiorentino, M. et al. Recurrent urinary tract infections in kidney transplant recipients during the first-year influence long-term graft function: a single-center retrospective cohort study. J Nephrol 32, 661–668 (2019). https://doi.org/10.1007/s40620-019-00591-5

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