title: Febrile urinary tract infection after pediatric kidney transplantation: a multicenter, prospective observational study.
abstract: BACKGROUND
  Febrile urinary tract infections (fUTIs) are common after kidney transplantation (KTx); however, prospective data in a multicenter pediatric cohort are lacking. We designed a prospective registry to record data on fUTI before and after pediatric KTx.
  
  
  METHODS
  Ninety-eight children (58 boys and 40 girls) ≤ 18 years from 14 mid-European centers received a kidney transplant and completed a 2-year follow-up.
  
  
  RESULTS
  Posttransplant, 38.7% of patients had at least one fUTI compared with 21.4% before KTx (p = 0.002). Before KTx, fUTI was more frequent in patients with congenital anomalies of kidneys and urinary tract (CAKUT) vs. patients without (38% vs. 12%; p = 0.005). After KTx, fUTI were equally frequent in both groups (48.7% vs. 32.2%; p = 0.14). First fUTI posttransplant occurred earlier in boys compared with girls: median range 4 vs. 13.5 years (p = 0.002). Graft function worsened (p < 0.001) during fUTI, but no difference was recorded after 2 years. At least one recurrence of fUTI was encountered in 58%.
  
  
  CONCLUSIONS
  This prospective study confirms a high incidence of fUTI after pediatric KTx, which is not restricted to patients with CAKUT; fUTIs have a negative impact on graft function during the infectious episode but not on 2-year graft outcome.
authors.affiliation: Pediatric Nephrology, University Medical Center Jena, Kochstrasse 2, 07743, Jena, Germany. Friederike.Weigel@med.uni-jena.de.
authors.forename: Friederike
authors.initials: F
authors.lastname: Weigel
authors.affiliation: Pediatric Nephrology, University Childrens Hospital, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Lemke
authors.affiliation: Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany.
authors.forename: Burkhard
authors.initials: B
authors.lastname: Tönshoff
authors.affiliation: Pediatric Nephrology, Hannover Medical School, Hannover, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Pape
authors.affiliation: Children's Hospital Memmingen, Memmingen, Germany.
authors.forename: Henry
authors.initials: H
authors.lastname: Fehrenbach
authors.affiliation: Pediatric Nephrology, Children's Hospital St. Georg, Leipzig, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Henn
authors.affiliation: Pediatric Nephrology, University Medical Center Bonn, Bonn, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hoppe
authors.affiliation: Department of Pediatrics I, University Medical Center Innsbruck, Innsbruck, Austria.
authors.forename: Therese
authors.initials: T
authors.lastname: Jungraithmayr
authors.affiliation: Pediatric Nephrology, University Medical Center Münster, Münster, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Konrad
authors.affiliation: Department of Nephrology, University Children's Hospital, Zurich, Switzerland.
authors.forename: Guido
authors.initials: G
authors.lastname: Laube
authors.affiliation: Pediatric Nephrology, University Children's Hospital, Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Pohl
authors.affiliation: 2nd School of Medicine, University Hospital Motol, Charles University Prague, Prague, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Seeman
authors.affiliation: Pediatric Nephrology, University Children's Hospital, Rostock, Germany.
authors.forename: Hagen
authors.initials: H
authors.lastname: Staude
authors.affiliation: Pediatric Nephrology, University Childrens Hospital, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Kemper
authors.affiliation: Pediatric Nephrology, University Medical Center Jena, Kochstrasse 2, 07743, Jena, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: John
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D051799:Delayed Graft Function / Q000453:epidemiology / Q000209:etiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000209:etiology; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000150:complications / Q000453:epidemiology* / Q000209:etiology
keywords: CAKUT; Children; Kidney transplantation; Outcome; Urinary tract infection