scholarly journals Acute Kidney Injury in Children with Kidney Transplantation

2018 ◽  
Vol 13 (11) ◽  
pp. 1721-1729 ◽  
Author(s):  
Omar Alkandari ◽  
Lieuko Nguyen ◽  
Diane Hebert ◽  
Valerie Langlois ◽  
Natasha A. Jawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Urinary Tract ◽  
Serum Creatinine ◽  
Urinary Tract Infections ◽  
Graft Loss ◽  
Rapid Progression ◽  
Kidney Transplant Recipients ◽  
Ckd Stage ◽  
Tract Infections

Background and objectivesAKI is associated with progression of CKD. Little is known about AKI after kidney transplantation in pediatric recipients. We aim to describe the epidemiology, risk factors, consequences, and outcomes of AKI in this population.Design, setting, participants, & measurementsWe performed a retrospective longitudinal analysis of pediatric kidney transplant recipients followed at The Hospital for Sick Children (Toronto, Canada) from 2001 to 2012. AKI was defined as an increase in serum creatinine ≥1.5 times baseline, and a rise of serum creatinine ≥1.25 but <1.5 times baseline defined subacute AKI.ResultsOf 179 children, 122 were eligible for analysis. At baseline (3 months post-transplant), median age of the children was 13 years old (interquartile range, 9–16 years old), and 53% had CKD stage 2. Congenital anomalies of the kidney and urinary tract accounted for 46% of children. Over the study period (12 years), the incidence of AKI was 37% (n=45 children), and 65% (79 children) experienced subacute AKI. Twenty-seven percent (33 children) did not develop AKI or subacute AKI. The main causes of AKI were infections other than urinary tract infections, rejection, and urinary tract infections. In a multivariable Poisson regression analysis, independent risk factors for AKI included younger age, girls, grafts from deceased donors, and lower baseline eGFR. AKI was significantly associated with lower long-term GFR and graft loss independent of rejection episodes. Moreover, subacute AKI was associated with progression of CKD.ConclusionsAKI and subacute AKI were common after pediatric kidney transplantation, and they were associated with graft loss, lower eGFR, and more rapid progression of CKD.

Guidance of antibiotic treatment for urinary tract infections in the early postoperative phase after Kidney Transplantation

2020 ◽  
Author(s):  
Jens Karl Hugo Strohäker ◽  
Silvio Nadalin ◽  
Alfred Königsrainer ◽  
Robert Bachmann
Keyword(s):  
Kidney Transplantation ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Asymptomatic Bacteriuria ◽  
Graft Function ◽  
Postoperative Phase ◽  
Kidney Transplant Recipients ◽  
Laboratory Findings ◽  
Gram Negative ◽  
Tract Infections

Abstract Purpose: Urinary tract infections are the most common infections early after kidney transplantation. The goals of this study were to evaluate our perioperative antibiotic protocol and risk factors for the occurrence of urinary tract and its effect on the early graft function. We evaluated laboratory alterations during episodes of UTI regarding their potential to guide treatment.Methods: Retrospective single-center analysis of all kidney transplant recipients of an academic transplant center between 2015 and 2017.Results: 96 patients were included in the study. Overall, in 22 patients a asymptomatic bacteriuria (ASB) was detected and 33 patients developed a urinary tract infection (UTI). Gram-negative UTIs appeared earlier than gram-positive UTIs. The most common lab findings during UTI were leukocytosis and CRP increase, both more common in gram-negative UTI (p .00 & .03). All complicated UTIs were caused by gram-negative bacteria (p .00). No difference in UTIs was seen between perioperative antibiotic regimens. Patients that suffered from UTIs showed less favorable graft function at discharge (GFR 43 vs 52 ml / min, p .03).Conclusion: UTIs are associated with worse graft functions while ASBs are not. Whether UTIs are caused by or lead to decreased graft function is still unclear. Proper gram-negative coverage is needed in cases of complicated UTIs or severe laboratory findings. Perioperative antibiotic regimens appear to have no beneficial influence on the incidence of UTIs.

Risk Factors for Urinary Tract Infections During the First Year After Kidney Transplantation

2010 ◽  
Vol 42 (1) ◽  
pp. 280-281 ◽  
Author(s):  
R. Sorto ◽  
S.S. Irizar ◽  
G. Delgadillo ◽  
J. Alberú ◽  
R. Correa-Rotter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
First Year ◽  
Tract Infections

Vitamin D Status has no Influence on the Incidence of Recurrent Urinary Tract Infections after Kidney Transplantation

2014 ◽  
Vol 12 (2) ◽  
pp. 114-118 ◽  
Author(s):  
Jean Jeanov Filipov ◽  
Borelli Kirilov Zlatkov ◽  
Emil Paskalev Dimitrov ◽  
Dobrin A. Svinarov
Keyword(s):  
Vitamin D ◽  
Kidney Transplantation ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Pleiotropic Effects ◽  
Kidney Transplant Recipients ◽  
Recurrent Utis ◽  
Recurrent Urinary Tract Infections ◽  
Significant Difference ◽  
Tract Infections

AbstractIntroduction.Recurrent urinary tract infections (rUTIs) after kidney transplantation (KT) are associated with significant decrease in graft survival. There is a growing body of evidence for the pleiotropic effects of vitamin D (VD), including immunomodulatory and antibacterial effect. The number of studies on VD’s pleiotropic effects in kidney transplant recipients (KTRs) however is low. The aim of our study was to assess the influence of VD on the incidence of recurrent UTIs after KT.Methods. The KTRs were tested for 25-hydroxyvitamin D (25VD) between 1.05.2012 and 30.11.2012. Patients within 12 months of transplantation, performed parathyroidectomy, concomitant intake of calcineurin inhibittors and mTOR inhibitors, advanced liver disease and VD supplementation were excluded from the study. Recurrent UTIs were defined as more than 3 episodes of active UTI within the last 12 months of testing for 25VD. Statistical analysis was carried out with SPSS version 22.0 and included descriptive statistics, Mann-Whitney U test. Determination of total 25VD was performed by a validated LC-MS/MS method.Results.A total of 275 patients met the above-mentioned criteria (males 182, females 93). The mean 25VD in patients with rUTIs (n=14) was 51.41±25.17 nmol/L, whereas in the group without rUTIs (n=261) the level was 60.35±23.29 nmol/L. After matching the two groups for seasonal factors (sampling for 25VD in July, August, September) and gender 169 patients were selected, and 11 were with rUTIs. No significant difference was detected in the 25VD level in the two groups (53.30±18.37 vs 49.08±21.04 nmol/L), p=0.342.Conclusions.Despite the higher 25VD in the KTRs without rUTIs, the difference between the two groups remained insignificant.

scholarly journals Urinary tract infections in renal transplant recipients at a quaternary care centre in Australia

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Simon OLENSKI ◽  
Carla SCUDERI ◽  
Alex CHOO ◽  
Aneesha Kaur BHAGAT SINGH ◽  
Mandy WAY ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Renal Transplant ◽  
Serum Creatinine ◽  
Urinary Tract Infections ◽  
Pneumocystis Carinii ◽  
Female Gender ◽  
Renal Transplant Recipients ◽  
Post Transplant ◽  
Tract Infections

Abstract Background Urinary tract infections (UTI) are the most common of infections after renal transplantation. The consequences of UTIs in this population are serious, with increased morbidity and hospitalisation rates as well as acute allograft dysfunction. UTIs may impair overall graft and patient survival. We aimed to identify the prevalence and risk factors for post-transplant UTIs and assess UTIs’ effect on renal function during a UTI episode and if they result in declining allograft function at 2 years post-transplant. Additionally, the causative organism, the class of antibacterial drug employed for each UTI episode and utilisation rates of trimethoprim/sulfamethoxazole (TMP/SMX) prophylaxis were also quantified. Methods This was a retrospective study of 72 renal transplant patients over a 5-year period who were managed at the Royal Brisbane and Women’s Hospital. Patient charts, pathology records and dispensing histories were reviewed as part of this study and all UTIs from 2 years post transplantation were captured. Results Of these patients, 20 (27.8%) had at least one UTI. Older age (p = 0.015), female gender (p < 0.001), hyperglycaemia (p = 0.037) and acute rejection episodes (p = 0.046) were risk factors for developing a UTI on unadjusted analysis. Female gender (OR 4.93) and age (OR 1.03) were statistically significant risk factors for a UTI on adjusted analysis. On average, there was a 14.4% (SEM 5.20) increase in serum creatinine during a UTI episode, which was statistically significant (p = 0.027), and a 9.1% (SEM 6.23) reduction in serum creatinine after the UTI episode trending toward statistical significance. (p = 0.076). Common organisms (Escherichia coli and Klebsiella pneumoniae) accounted for 82% of UTI episodes with 70% of UTI cases requiring only a single course of antibiotic treatment. Furthermore, the antibiotic class used was either a penicillin (49%) or cephalosporin (36%) in the majority of UTIs. The use of TMP/SMX prophylaxis for Pneumocystis carinii pneumonia prophylaxis did not influence the rate of UTI, with > 90% of the cohort using this treatment. Conclusions There was no significant change in serum creatinine and estimated glomerular filtrate rate from baseline to 2 years post-transplant between those with and without a UTI.

Antibiotics for preventing urinary tract infections in kidney transplant recipients

2006 ◽  
Author(s):  
Abdulmalik M Alkatheri ◽  
Ali Hajeer ◽  
Hanan Al Kadri ◽  
Majed Al-Jeraisy ◽  
Abullah Alsayyari
Keyword(s):  
Urinary Tract ◽  
Kidney Transplant ◽  
Urinary Tract Infections ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Tract Infections

Urinary Tract Infections Caused by Multi-Drug Resistant Proteus mirabilis: Risk Factors and Clinical Outcomes

Infection ◽  
2009 ◽  
Vol 38 (1) ◽  
pp. 41-46 ◽  
Author(s):  
K. Cohen-Nahum ◽  
L. Saidel-Odes ◽  
K. Riesenberg ◽  
F. Schlaeffer ◽  
A. Borer
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Clinical Outcomes ◽  
Urinary Tract Infections ◽  
Proteus Mirabilis ◽  
Drug Resistant ◽  
Tract Infections
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