| High prevalence of febrile urinary tract infections after paediatric renal transplantation. | |
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MedLine Citation:
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PMID: 16963479 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Multicenter Study Date: 2006-09-08 |
Journal Detail:
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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:
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Created Date: 2006-10-13 Completed Date: 2007-01-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
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Languages: eng Pagination: 3269-74 Citation Subset: IM |
Affiliation:
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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:
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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 |
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