S OLENSKI1,2,3, C SCUDERI1,3, A CHOO1, AK BHAGAT SINGH1, M WAY4, A PELECANOS4, L JEYASEELAN5, G JOHN1
1Royal Brisbane and Women’s Hospital, Brisbane, Australia, 2Princess Alexandra Hospital, Brisbane, Australia, 3University of Queensland , Brisbane, Australia, 4QIMR Berghofer Medical Research Institute, Brisbane , Australia, 5Christian Medical College, Vellore , India
Aim: To identify the prevalence and risk factors for post-transplant urinary tract infections (UTI). To assess if UTIs affect renal function around the time of UTI and if they result in declining allograft function at 2 years.
Background: UTIs are the most common infections experienced by renal transplant recipients. The consequences of UTIs in this population are serious with increased morbidity and hospitalisation rates as well as acute allograft dysfunction. The literature is divided on whether UTIs impair overall graft and patient survival.
Methods: This is a retrospective study of 72 patients who had a renal transplant during a 5 year period and received follow-up at the Royal Brisbane and Women’s Hospital. Patients were stratified into two groups according to the presence or absence of at least one UTI episode.
Results: Among the 72 patients who had a renal transplant, 20 (28%) had at least one UTI. Older age (p=0.015), female gender (p <0.001) and hyperglycaemia (p=0.037) were risk factors for developing a UTI. Female gender (OR 8.54), pre-existing urogenital abnormality (OR 12.96) and CMV viraemia at any time-point (OR 10.77) were statistically significant risk factors for a UTI on adjusted analysis. Serum creatinine was on average 21 points higher during a UTI episode compared to pre-UTI creatinine values (p=0.027). Serum creatinine was on average 16 points lower after a UTI episode as compared to during an episode (p=0.076). There was no significant change in serum creatinine and eGFR from baseline out to 2 years between those with and without a UTI.
Conclusions: In this cohort, UTIs acutely affected renal function during an episode however they did not impair overall renal function at 2 years.
Dr Simon Olenski is an Advanced Trainee in Nephrology undertaking his second year of training at the Princess Alexandra Hospital. He has a diverse range of interests within Nephrology including early prevention and management of Chronic Kidney Disease, Home Therapies, Kidney Supportive Care and Clinical Leadership