THE IMPACT OF URINARY TRACT INFECTION ON RENAL ALLOGRAFT FUNCTION IN LIVING-RELATED KIDNEY TRANSPLANT RECIPIENTS

Introduction:

The most frequent complication following kidney transplantation is urinary tract infection (UTI), which contributes to morbidity, graft failure and a significant negative impact on quality of life in living-related kidney transplant recipients (LRKTR). Urinary tract infection may increase the likelihood of poorer renal allograft outcomes. The aim of the study was to evaluate the impact of urinary tract infection on renal allograft function in living-related kidney transplant recipients. 

Methods:

It was a hospital-based prospective study done at Nephrology unit of No. (1) Defence Services General Hospital (1000-bedded) from October 2020 to September 2022. Total 46 participants were enrolled and they were evaluated for urinary tract infection at various time points after transplant (day 3, day 7, day 30, and 3month, 6month and at the time of symptomatic infection).

Results:

Nearly two third of LRKTR (67.3%) developed urinary tract infection (UTI) after the transplant. The most common organism was Enterobacter cloacae (34.2%), followed by Escherichia coli (26.3%) and Pseudomonas species (23.7%). The most sensitive antimicrobial class was aminoglycoside groups (81%), followed by cephalosporins groups (35%) and carbapenems (35%). Both ATG and basiliximab inductions were common to develop UTI. History of pregnancy before transplant, pre-transplant diabetes mellitus, post-transplant diabetes mellitus and acute rejection were found to be risk factors for UTI; pre-transplant diabetes mellitus was the only factor with significant association (p=0.046).

 Serum creatinine levels were measured and compared at three different times to determine the impact of UTI on renal allograft function; before UTI , during the attack of UTI and after completing treatment for UTI. During these times, the mean ± SD serum creatinine levels were 1.22 ± 0.65 (before UTI), 1.36 ± 0.45 (during UTI), and 1.12 ± 0.27(after treatment for UTI), with p values of 0.006, 0.002, and 0.004, respectively, indicating that these mean serum creatinine values were statistically significant and different from each time point. UTI caused deterioration in renal function. The appropriate treatment resulted in improvement in renal function. 

Conclusions:

Urinary tract infection was common in LRKTR; therefore, awareness was important. It had negative impact on renal allograft function in LRKTR. Appropriate treatment improved renal allograft function in LRKTR. 

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.