title: Effect of ureteric stents on urological infection and graft function following renal transplantation.
abstract: OBJECTIVE
  To compare urological infections in patients with or without stents following transplantation and to determine the effect of such infections on graft function.
  
  
  METHODS
  All 285 recipients of kidney transplantation at our centre between 2006 and 2010 were included in the study. Detailed information including stent use and transplant function was collected prospectively and analysed retrospectively. The diagnosis of urinary tract infection was made on the basis of compatible symptoms supported by urinalysis and/or microbiological culture. Graft function, estimated glomerular filtration rate and creatinine at 6 mo and 12 mo, immediate graft function and infection rates were compared between those with a stent or without a stent.
  
  
  RESULTS
  Overall, 196 (183 during initial procedure, 13 at reoperation) patients were stented following transplantation. The overall urine leak rate was 4.3% (12/277) with no difference between those with or without stents - 7/183 vs 5/102, P = 0.746. Overall, 54% (99/183) of stented patients developed a urological infection compared to 38.1% (32/84) of those without stents (P = 0.0151). All 18 major urological infections occurred in those with stents. The use of stent (Wald χ(2) = 5.505, P = 0.019) and diabetes mellitus (Wald χ(2) = 5.197, P = 0.023) were found to have significant influence on urological infection rates on multivariate analysis. There were no deaths or graft losses due to infection. Stenting was associated with poorer transplant function at 12 mo.
  
  
  CONCLUSIONS
  Stents increase the risks of urological infections and have a detrimental effect on early to medium term renal transplant function.
authors.affiliation: Jacob A Akoh, Tahawar Rana, South West Transplant Centre, Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth PL6 8DH, United Kingdom.
authors.forename: Jacob A
authors.initials: JA
authors.lastname: Akoh
authors.forename: Tahawar
authors.initials: T
authors.lastname: Rana
keywords: Creatinine; Estimated glomerular filtration rate; Renal transplantation; Ureteric stent; Urological infection