Urinary tract infection in patients with urological complications after renal transplantation with respect to long-term function and allograft survival.

Urological complications after renal transplantation (urinary fistula, urinary tract dilatation) are frequently associated with urinary tract infections (UTI). We tried to analyse whether urinary tract infection was one of the factors which participated in the lower allograft survival rates and reduced allograft function in urologically complicated (UC) patients. We observed 77 patients after renal transplantation (Tx) of whom 42 had urinary fistula, 32 had urinary tract dilatation a 3 had both complications (I/1992-XII/1996). 100 patients without urological complications represented a control group (N). Obtained data was statistically evaluated using t-test, chi 2-test, correlation analysis. Graft and patient survival rates were assessed using the Kaplan-Meier method. We have found that UC patients after Tx had a worse renal function compared with patients not suffering from this complication. Using Kaplan-Meier methods we have found that graft survival rate in patients with UC is significantly lower than that in the control group (5-year graft survival 0.6 vs 0.82, p < 0.01). On the other hand there were no differences in the 5-year patients survival rate between the followed groups of patients (0.74 vs 0.83). There was no significant correlation between predicted creatinine clearance and followed indicators of UTI--total time of positive urine bacterial cultivation, number of infectious periods and total time of antibiotic therapy. There were no significant differences in graft survival during 5 years between patients with UTI and without UTI. Our results suggest that patients with UC are at increased risk of urinary tract infection. Our findings are in keeping with the assumption that UTI in patients with UC do not significantly participate in the decreased level of graft function and the shorter graft survival rates.