A Current Review of the Etiology, Clinical Features, and Diagnosis of Urinary Tract Infection in Renal Transplant Patients.

Urinary tract infection (UTI) represents the most common infection after kidney transplantation and remains a major cause of morbidity and mortality in kidney transplant (KT) recipients, with a potential impact on graft survival. UTIs after KT are usually caused by Gram-negative microorganisms. Other pathogens which are uncommon in the general population should be considered in KT patients, especially BK virus since an early diagnosis is necessary to improve the prognosis. UTIs following kidney transplantation are classified into acute simple cystitis, acute pyelonephritis/complicated UTI, and recurrent UTI, due to their different clinical presentation, prognosis, and management. Asymptomatic bacteriuria (ASB) represents a frequent finding after kidney transplantation, but ASB is considered to be a separate entity apart from UTI since it is not necessarily a disease state. In fact, current guidelines do not recommend routine screening and treatment of ASB in KT patients, since a beneficial effect has not been shown. Harmful effects such as the development of multidrug-resistant (MDR) bacteria and a higher incidence of Clostridium difficile diarrhea have been associated with the antibiotic treatment of ASB.

Úlceras en el colon tras la toma de resina de poliestireno sulfonato cálcico / Colonic mucosal ulceration following administration of calcium polystryrene sulfonate

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Utilidad de la maniobra alfa en la malposición del catéter peritoneal: revisión y experiencia / Usefulness of the alpha maneuver in the peritoneal catheter displacement: review and experience

INTRODUCCIÓN Y OBJETIVOS: La malposición del catéter peritoneal es una de las complicaciones más frecuentes de la diálisis peritoneal. Para recolocarlo se ha propuesto realizar la maniobra alfa, que consiste en devolver al catéter a su correcta posición a través de unas guías rígidas bajo control fluoroscópico. El objetivo del presente estudio es analizar los 107 procedimientos realizados en nuestro Centro tratando de determinar factores que puedan predecir el éxito de la técnica. MATERIAL Y MÉTODOS: El método de la maniobra alfa fue utilizado en 86 pacientes con un total de 107 procedimientos (en 70 pacientes solo una maniobra, en 16 pacientes dos maniobras o más). RESULTADOS: El éxito global de la técnica fue de un 60%. La tasa de éxito no mostró diferencias en cuanto al sexo (60% en varones frente a 40% mujeres, p = 0,104), tiempo de fallo del catéter (fallos precoces 60% frente a fallos tardíos 62%, p = 0,849), tipo de catéter (75% en autoposicionantes frente a 58% en espirales, p = 0,633), ni en cuanto a la posición inicial del catéter. Sólo hubo un caso de peritonitis secundaria al procedimiento. CONCLUSIONES: La maniobra alfa es un método eficaz y seguro en la corrección de la malposición del catéter peritoneal

INTRODUCTION AND OBJECTIVES: Peritoneal catheter displacement is one of the most common complications of peritoneal dialysis. The alpha manoeuvre has been proposed as a repositioning technique, which involves returning the catheter to its correct position using rigid guidewires under fluoroscopic guidance. The aim of this study is to analyse the 107 procedures performed at our Centre to identify factors that may predict the success of the technique. MATERIAL AND METHODS: The alpha manoeuvre method was used in 86 patients, with a total of 107 procedures (70 patients underwent one manoeuvre only, 16 patients underwent two or more manoeuvres). RESULTS: The overall success rate of the technique was 60%. There were no differences in success rate in terms of gender (60% male vs. 40% female, p = 0.104), time of catheter failure (early 60% vs. late 62%, p = 0.849), type of catheter (75% self-locating vs. 58% spiral, p = 0.633) or the initial position of the catheter. There was only one case of peritonitis related to the procedure. CONCLUSIONS: The alpha manoeuvre is an effective and safe method for correcting peritoneal catheter displacement

Usefulness of the alpha maneuver in the peritoneal catheter displacement: review and experience. / Utilidad de la maniobra alfa en la malposición del catéter peritoneal: revisión y experiencia.

INTRODUCTION AND OBJECTIVES: Peritoneal catheter displacement is one of the most common complications of peritoneal dialysis. The alpha manoeuvre has been proposed as a repositioning technique, which involves returning the catheter to its correct position using rigid guidewires under fluoroscopic guidance. The aim of this study is to analyse the 107 procedures performed at our Centre to identify factors that may predict the success of the technique. MATERIAL AND METHODS: The alpha manoeuvre method was used in 86 patients, with a total of 107 procedures (70 patients underwent one manoeuvre only, 16 patients underwent two or more manoeuvres). RESULTS: The overall success rate of the technique was 60%. There were no differences in success rate in terms of gender (60% male vs. 40% female, p = 0.104), time of catheter failure (early 60% vs. late 62%, p = 0.849), type of catheter (75% self-locating vs. 58% spiral, p = 0.633) or the initial position of the catheter. There was only one case of peritonitis related to the procedure. CONCLUSIONS: The alpha manoeuvre is an effective and safe method for correcting peritoneal catheter displacement.