Impact of Complicated Urinary Tract Infection on Renal Graft Function.

ABSTRACT

BACKGROUND: Urinary tract infection (UTI) is the most common infectious complication after renal transplantation. It is uncertain whether the development of UTI has an impact on renal graft function. The objective of this study was to evaluate the effects of complicated and recurrent UTI on 2-year renal graft function. METHODS: This was a historical cohort study in renal transplantation patients in a kidney transplant center. All renal transplant recipients from June 2004 to September 2016 were included. A linear regression analysis was performed to study the association between the outcome (variation in estimated glomerular filtration rate [eGFR] by the Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI] equation between month 1 and month 24 post-transplant) and the UTI. The approval of the Ethics and Research Committee to carry out this study was obtained. RESULTS: In total, 276 kidney transplants were performed during the observation period. Of the transplant patients, 193 (69.9%) did not develop a UTI and 83 (30.1%) presented at least 1 complicated UTI. Patients who presented at least 1 UTI had a variation in eGFR during the observation period of -12.6 mL/min/1.73 m2 (95% confidence interval [CI] -4.5 to -20.7 mL/min/1.73 m2; P = .02), compared with those without a UTI. Said difference persisted in the adjusted model controlling for variables that have an impact on the eGFR. This difference was -10.7 mL/min/1.73 m2 (95% CI -3.1 to -18.2 mL/min/1.73 m2; P = .006). CONCLUSION: The findings suggest that the occurrence of complicated UTI has a negative impact on graft function and that prevention and monitoring of UTIs should be stepped up to avoid their deleterious effects on graft function.