title: Urinary tract infections in pediatric renal transplant recipients--a two center risk factors study.
abstract: UTI are common in renal Tx recipients and may significantly impact on the graft function. The aim of our study was to evaluate the prevalence, risk factors, and significance of UTI in Tx children. We performed a retrospective cross-sectional study of 76 Tx patients, median age at Tx was 13.4 yr. Twenty-one of 76 (28%) patients developed at least one UTI during the mean follow-up time of 3.3 +/- 2.0 yr post-Tx. The first UTI occurred at a median of 160 days post-Tx. The RR of having UTI was significantly higher in patients with the primary diagnosis of obstructive uropathy (RR = 2.6, 95th CI = 1.1-6.0, p = 0.032), history of PN pre Tx (RR = 2.7, 95th CI = 1.3-5.4, p = 0.009) and pre Tx VUR (RR = 2.2, 95th CI = 1.1-4.5, p = 0.045). These three factors also significantly decreased the infection-free survival time to the first UTI. Most UTI caused reversible acute allograft dysfunction, but the long-term graft function could not be reliably assessed with SCr. In conclusion, UTI occurred in 28% of pediatric Tx recipients, mostly during the first year post-Tx despite antibiotic prophylaxis. The diagnosis of obstructive uropathy, history of UTI and VUR prior to Tx were significant risk factors.
authors.affiliation: Division of Pediatric Nephrology, Children's Hospital of Eastern Ontario, Ottawa, Canada. jfeber@cheo.on.ca
authors.forename: Janusz
authors.initials: J
authors.lastname: Feber
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Spatenka
authors.forename: Tomas
authors.initials: T
authors.lastname: Seeman
authors.forename: Karel
authors.initials: K
authors.lastname: Matousovic
authors.forename: Lubos
authors.initials: L
authors.lastname: Zeman
authors.forename: Jiri
authors.initials: J
authors.lastname: Dusek
authors.forename: Jiri
authors.initials: J
authors.lastname: Morávek
authors.forename: Jan
authors.initials: J
authors.lastname: Janda
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Barrowman
authors.forename: Luis
authors.initials: L
authors.lastname: Guerra
authors.forename: Michael
authors.initials: M
authors.lastname: Leonard
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000628:therapy*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D011704:Pyelonephritis / Q000150:complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000150:complications* / Q000209:etiology