Document Detail


High prevalence of febrile urinary tract infections after paediatric renal transplantation.
MedLine Citation:
PMID:  16963479     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Adult data suggest that urinary tract infections occur frequently after renal transplantation (RTx) and contribute to mortality and graft loss; data in children are limited. Therefore, we evaluated prevalence, short and long-term morbidity and confounding factors of febrile UTI (fUTI) after paediatric RTx. METHODS: In a retrospective cross-sectional study of three centres, we analysed data on 110 children followed for 4.9+/-3.4 years after successful transplantation. RESULTS: 40/110 (36%) patients had at least one fUTI at a median time of 0.98 years (range 0.02-8.96) after RTx; 11 patients (28%) had recurrent fUTI. Serum creatinine (SCr) rose significantly from 1.15+/-1.13 to 1.83+/-1.69 mg/dl, (P<0.001) during the fUTI, declining to baseline values after treatment. At the last followed-up calculated mean, GFR was comparable between fUTI and non-fUTI groups (75+/-26 vs 71+/-22 ml/min/1.73 m2). During fUTI mean, C-reactive protein (CRP) increased to 123+/-75 mg/l. Febrile UTI were significantly more frequent in girls compared to boys (22/44 vs 18/66, P<0.05) but occurred significantly earlier in boys than in girls [median 0.63 (range 0.02-4.15) vs 1.07 (0.04-8.96) years after RTx; P<0.02]. Also, patients with urinary tract malformations (UTMs) and neurogenic bladder as underlying diagnosis and those with urological surgery prior to transplantation had an increased risk for fUTI. CONCLUSION: fUTI is a frequent complication with significant short-term morbidity especially in girls and children with UTMs, neurogenic bladder and those with urological surgery. Long-term follow-up and prospective studies confirming specific risk factors, preventive measures and impact on graft survival are necessary.
Authors:
Ulrike John; Anne Schulze Everding; Eberhard Kuwertz-Bröking; Monika Bulla; Dirk E Müller-Wiefel; Joachim Misselwitz; Markus J Kemper
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2006-09-08
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  21     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-13     Completed Date:  2007-01-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  3269-74     Citation Subset:  IM    
Affiliation:
Department of Pediatric Nephrology, Friedrich Schiller University Children's Hospital, Kochstrasse 2, D-07740 Jena, Germany. ulrike.john@med.uni-jena.de
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MeSH Terms
Descriptor/Qualifier:
Child
Cross-Sectional Studies
Female
Fever / epidemiology*
Germany / epidemiology
Humans
Kidney Failure, Chronic / epidemiology,  microbiology,  therapy
Kidney Transplantation* / adverse effects
Male
Prevalence
Recurrence
Retrospective Studies
Risk Factors
Urinary Tract / abnormalities
Urinary Tract Infections / diagnosis,  epidemiology*,  microbiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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