Urinary Tract Infection in Kidney Transplant Recipients: The predictors and two-year outcomes

Abstract

Background: Urinary tract infection (UTI) is the most common infection in kidney transplant recipients (KTR). Our aim in this study is to determine the prevalence, risk factors, and causative microorganisms of UTI. In addition, to compare the kidney functions of the patients in the 2nd year who developed and did not develop UTI after transplantation. Method: Two hundred sixteen patients underwent kidney transplantation in our center between July 2012 and March 2020. A total of 206 patients with 267 episodes of UTI were included in the study. The impacts of catheterization, hemodialysis duration, gender, posttransplant prolonged hospital stay on UTI development, and UTI on two-year allograft functions, were evaluated. Results: The mean age of the study patients was 34.5±12.7, and 43.7% of them were women. At least one UTI attack developed in 38.8% (80/206) of the KTR. Thirty-one KTR developed recurrent UTI (R-UTI). UTI incidence was found 38.8% in our cohort. Female gender, posttransplant prolonged hospital stay, presence of prolonged double-j stent and foley catheter durations were found associated with UTI development. (p<0.001, p<0.001, p<0.001, p<0.001, respectively). The mean estimated glomerular filtration rate eGFR in KTR with UTI at 2-year post-transplant was significantly lower than KTR without UTI (71.2±29.2 vs 82.4±23.9; p=0.006). Low eGFR was more prominent among the KTR with R-UTI (69.9±31.6). Escherichia coli and Klebsiella pneumonia were the most frequently isolated microorganisms in our cohort. Conclusions: This study demonstrated UTI may have an adverse impact on allograft function in KTR, especially in KTR with R-UTI.