Friederike Weigel1, Anja Lemke2, Burkhard Tönshoff3, Lars Pape4, Henry Fehrenbach5, Michael Henn6, Bernd Hoppe7, Therese Jungraithmayr8, Martin Konrad9, Guido Laube10, Martin Pohl11, Tomáš Seeman12, Hagen Staude13, Markus J Kemper2, Ulrike John14. 1. Pediatric Nephrology, University Medical Center Jena, Kochstrasse 2, 07743, Jena, Germany. Friederike.Weigel@med.uni-jena.de. 2. Pediatric Nephrology, University Childrens Hospital, University Medical Center Hamburg Eppendorf, Hamburg, Germany. 3. Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany. 4. Pediatric Nephrology, Hannover Medical School, Hannover, Germany. 5. Children's Hospital Memmingen, Memmingen, Germany. 6. Pediatric Nephrology, Children's Hospital St. Georg, Leipzig, Germany. 7. Pediatric Nephrology, University Medical Center Bonn, Bonn, Germany. 8. Department of Pediatrics I, University Medical Center Innsbruck, Innsbruck, Austria. 9. Pediatric Nephrology, University Medical Center Münster, Münster, Germany. 10. Department of Nephrology, University Children's Hospital, Zurich, Switzerland. 11. Pediatric Nephrology, University Children's Hospital, Freiburg, Germany. 12. 2nd School of Medicine, University Hospital Motol, Charles University Prague, Prague, Czech Republic. 13. Pediatric Nephrology, University Children's Hospital, Rostock, Germany. 14. Pediatric Nephrology, University Medical Center Jena, Kochstrasse 2, 07743, Jena, Germany.
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%. CONCLUSION: 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.
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%. CONCLUSION: 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: Ella J Ariza-Heredia; Elena N Beam; Timothy G Lesnick; Walter K Kremers; Fernando G Cosio; Raymund R Razonable Journal: Ann Transplant Date: 2013-05-06 Impact factor: 1.530
Authors: George J Alangaden; Rama Thyagarajan; Scott A Gruber; Katherina Morawski; James Garnick; Jose M El-Amm; Miguel S West; Dale H Sillix; Pranatharthi H Chandrasekar; Abdolreza Haririan Journal: Clin Transplant Date: 2006 Jul-Aug Impact factor: 2.863
Authors: G Pellé; S Vimont; P P Levy; A Hertig; N Ouali; C Chassin; G Arlet; E Rondeau; A Vandewalle Journal: Am J Transplant Date: 2007-02-07 Impact factor: 8.086
Authors: M Mochon; B A Kaiser; S Dunn; J Palmer; M S Polinsky; S L Schulman; J T Flynn; H J Baluarte Journal: J Urol Date: 1992-12 Impact factor: 7.450