Introduction:
Infection is the second leading cause of mortality among kidney transplant recipients. However, in resource-limited countries, infections in patients with a functioning graft remain the most prevalent cause of death. The susceptibility to infections, particularly opportunistic ones, in kidney transplant recipients (KTRs) is primarily influenced by the complex interplay between the overall state of immunosuppression and the recipient’s environmental exposure. This study aims to evaluate the risk factors associated with severe infections in KTRs, including demographic variables, immunosuppressive therapy-related factors, the presence of diabetes, and environmental conditions.
Methods:
This prospective observational study involved comparing kidney transplant recipients who experienced infections necessitating hospitalization with 50 control patients who did not develop any severe infections. We collected and recorded demographic information, clinical data, and laboratory findings for both cases and controls. The data were analyzed using SPSS software to identify significant variables.
Results:
Several demographic and environmental factors were significantly associated with infections in the case group, including lower socioeconomic status, overcrowding, use of water coolers, and exposure to pet dogs. Additionally, the development of diabetes post-transplant was identified as a significant risk factor for infections in KTRs (p-value < 0.05). Among the infection group, 50% had received induction therapy, compared to 28% in the control group (p-value < 0.05). Half of the reported infections were localized to the pulmonary system, with polymicrobial infections being the most common. Patients in the infection group also exhibited lower hemoglobin levels, a higher neutrophil-to-lymphocyte ratio, reduced estimated glomerular filtration rate (eGFR), elevated ferritin levels, and lower albumin levels compared to the control group.
Conclusions:
This study identified multiple risk factors associated with severe infections in KTRs, including socioeconomic, environmental, and clinical factors. Recognizing these high-risk patients can help develop targeted strategies to mitigate the risk of infections. These findings provide important insights for future research and clinical practice in managing severe infections following kidney transplants.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.