title: Prophylaxis of recurrent urinary tract infection after renal transplantation by cranberry juice and L-methionine.
abstract: BACKGROUND
  Recurrent urinary tract infections (UTIs) increase mortality and reduce graft survival after renal transplantation. Strategies to prevent recurrent UTIs include L-methionine, cranberry juice, and antibiotics. Data on the efficacy of cranberry and L-methionine, however, are controversial in the general population; there are few data in renal transplant recipients.
  
  
  METHODS
  We performed a retrospective analysis of 82 transplant recipients with recurrent UTIs, who underwent prophylaxis with cranberry juice (2 × 50 mL/d, n = 39, 47.6%), or L-methionine (3 × 500 mg/d, n = 25, 30.5%), or both modalities (n = 18, 21.9%). Thirty patients without prophylaxis served as controls. We analyzed symptoms, pyuria/nitrituria, and incidence of UTI events during 1 year before versus after initiation of prophylaxis.
  
  
  RESULTS
  Prophylaxis highly significantly decreased the annual UTI incidence by 58.3% (P < .001) in the study population with no change in the control group (P = .85); in addition, 53.7% of symptomatic patients reported relief of symptoms and pyuria/nitrituria disappeared in 42.4% of the dipstick-positive patients (P < .001 each). Cranberry reduced the annual number of UTI episodes by 63.9% from 3.6 ± 1.4 to 1.3 ± 1.3/year (P < .001) and L-methionine by 48.7% from 3.9 ± 1.8 to 2.0 ± 1.3/year (P < .001).
  
  
  CONCLUSIONS
  Cranberry juice and L-methionine successfully reduced the incidence of UTI after renal transplantation.
authors.affiliation: Department of Nephrology, Charité-Campus Benjamin Franklin, Berlin, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Pagonas
authors.forename: J
authors.initials: J
authors.lastname: Hörstrup
authors.forename: D
authors.initials: D
authors.lastname: Schmidt
authors.forename: P
authors.initials: P
authors.lastname: Benz
authors.forename: R
authors.initials: R
authors.lastname: Schindler
authors.forename: P
authors.initials: P
authors.lastname: Reinke
authors.forename: M
authors.initials: M
authors.lastname: van der Giet
authors.forename: W
authors.initials: W
authors.lastname: Zidek
authors.forename: T H
authors.initials: TH
authors.lastname: Westhoff
mesh_terms: D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001628:Beverages / Q000009:adverse effects; D016009:Chi-Square Distribution; D005260:Female; D005638:Fruit; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008715:Methionine / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010946:Plants, Medicinal; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D029799:Vaccinium macrocarpon
chemical_list: D000890:Anti-Infective Agents; D008715:Methionine