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Urinary tract infection following kidney transplantation: frequency, risk factors and graft function

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Abstract

The aim of this study was to determine the proportion of children who develop urinary tract infection (UTI) after kidney transplantation (KTx) and to identify the factors associated with UTI and its impact on graft function. To this end, we undertook a chart review of children who underwent KTx at Red Cross Children’s Hospital between January 2003 and December 2009 and were followed-up for at least 6 months after transplantation. Sixty-two children (53.2% males) were followed-up for a mean (standard deviation) period of 36.9 (19.7) months. Mean age at transplantation was 10.0 (4.6) years. Twenty-five (40.3%) children had 89 UTI episodes during the study period, equivalent to 0.94 UTI episodes per one patient-year of follow-up. Acute pyelonephritis occurred in 17 (27.4%) children; another 17 (27.4%) had multiple post-KTx UTI. Klebsiella (40.0%) and Escherichia (28.0%) were the commonest organisms. Those with post-KTx UTI were, at transplantation, younger (8.3 vs. 11.2 years; p = 0.017), had lower urinary tract abnormality (LUTA) (13 vs. 1; p = 0.000) and had pre-KTx UTI (13 vs. 5; p = 0.001). Multivariate analysis revealed that only age <5 years at transplantation and LUTA remained significant and that UTI KTx was not associated with worsening graft function. UTI is common after post-KTx. Among our patient cohort, younger age and LUTA were risk factors, but UTI did not affect graft function.

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Acknowledgements

We are grateful to the International Pediatric Nephrology Association (IPNA) for providing a fellowship grant to Dr. C.I. Esezobor without which the opportunity to conduct the study would not have arisen. We also appreciate the medical doctors at Red Cross War Memorial Children Hospital and those providing follow-up who helped in data collection.

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Authors and Affiliations

  1. Department of Paediatrics, College of Medicine, University of Lagos, P.M.B 12003, Lagos, Nigeria

    Christopher Imokhuede Esezobor

  2. Department of Pediatric Medicine, Red Cross War Memorial Children’s Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa

    Peter Nourse & Priya Gajjar

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  1. Christopher Imokhuede Esezobor
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  2. Peter Nourse
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  3. Priya Gajjar
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Correspondence to Christopher Imokhuede Esezobor.

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Esezobor, C.I., Nourse, P. & Gajjar, P. Urinary tract infection following kidney transplantation: frequency, risk factors and graft function. Pediatr Nephrol 27, 651–657 (2012). https://doi.org/10.1007/s00467-011-2044-1

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  • DOI: https://doi.org/10.1007/s00467-011-2044-1

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