Risk factors for urinary tract infection after renal transplantation and its impact on graft function in children and young adults.
OBJECTIVE
Urinary tract infection will develop in 40% of children who undergo renal transplantation. Post-transplant urinary tract infection is associated with earlier graft loss in adults. However, the impact on graft function in the pediatric population is less well-known. Additionally the risk factors for post-transplant urinary tract infection in children have not been well elucidated. The purpose of this study was to assess the relationship between pre-transplant and post-transplant urinary tract infections on graft outcome, and the risk factors for post-transplant urinary tract infection.


METHODS
A total of 87 patients underwent renal transplantation between July 2001 and July 2006. Patient demographics, cause of renal failure, graft outcome, and presence of pre-transplant and post-transplant urinary tract infections were recorded. Graft outcome was based on last creatinine and nephrological assessment.


RESULTS
Median followup was 3.12 years. Of the patients 15% had pre-transplant and 32% had post-transplant urinary tract infections. Good graft function was seen in 60% of the patients and 21% had failed function. Graft function did not correlate with a history of pre-transplant or post-transplant urinary tract infection (p >0.2). Of transplanted patients with urological causes of renal failure 57% had post-transplant urinary tract infection, compared to only 20% of those with a medical etiology of renal failure (p <0.001).


CONCLUSIONS
In this study there was no correlation between a history of urinary tract infection (either before or after transplant) and decreased graft function. History of pre-transplant urinary tract infection was suggestive of urinary tract infection after transplant. Patients with urological causes of renal failure may be at increased risk for post-transplant urinary tract infection.
Silva
Andres
A
Department of Urology, Children's Hospital, Boston, Massachusetts 02115, USA.
Rodig
Nancy
N
Passerotti
Carlo P
CP
Recabal
Pedro
P
Borer
Joseph G
JG
Retik
Alan B
AB
Nguyen
Hiep T
HT
D000293:Adolescent; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000502:physiology*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000209:etiology*