Erschienen in:
11.01.2016 | Original Article
Febrile urinary tract infection after pediatric kidney transplantation: a multicenter, prospective observational study
verfasst von:
Friederike Weigel, Anja Lemke, Burkhard Tönshoff, Lars Pape, Henry Fehrenbach, Michael Henn, Bernd Hoppe, Therese Jungraithmayr, Martin Konrad, Guido Laube, Martin Pohl, Tomáš Seeman, Hagen Staude, Markus J. Kemper, Ulrike John
Erschienen in:
Pediatric Nephrology
|
Ausgabe 6/2016
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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.