Ciszek Michał, Paczek Leszek, Bartłomiejczyk Irena, Mucha Krzysztof
Department of Immunology, Transplantology and Internal Disease, Transplantation Institute, Medical University of Warsaw, Warsaw, Poland.
Transplantation. 2006 Jun 27;81(12):1653-7. doi: 10.1097/01.tp.0000226072.20185.f8.
The role of asymptomatic bacteriuria in kidney transplant recipients is unknown. There is no clear evidence of its effect on transplanted kidney.
We studied urine cytokines profile among kidney transplant recipients with bacteriuria found in screening examination. Urine cultures were collected in 269 patients with stable graft function and serum creatinine level <2 mg/dl, during their routine visits. Interleukin (IL)-6 and IL-8 levels were measured in urine samples from patients with asymptomatic bacteriuria, symptomatic urinary tract infection and patients without bacteriuria (control group). Changes in serum creatinine level in patients with asymptomatic bacteriuria and in the control group were observed during 12 months follow up.
Urinary tract infection (UTI) was diagnosed in five patients and asymptomatic bacteriuria in 22 patients. Urine IL-6 level was significantly higher in symptomatic UTI group (median 15.71 pg/mg) but there were no differences between group of patients with asymptomatic bacteriuria (3.92 pg/mg) and control group (2.54 pg/mg). Urine IL-8 level was higher in symptomatic UTI group (median 146.8 pg/mg) and was also significantly higher in asymptomatic bacteriuria group (33.49 pg/mg) in comparison to control group (2.97 pg/mg; P=0.0002). During 1-year follow up, incidence of UTI was higher in the asymptomatic bacteriuria group than in the control group but graft function was not different in both groups.
Elevated urine IL-8 level in kidney transplant patients with asymptomatic bacteriuria may reflect impaired immune response to bacterial infection and occult inflammatory process in urinary tract.
无症状菌尿在肾移植受者中的作用尚不清楚。尚无明确证据表明其对移植肾有影响。
我们研究了在筛查中发现有菌尿的肾移植受者的尿细胞因子谱。在269例移植肾功能稳定且血清肌酐水平<2mg/dl的患者常规就诊期间收集尿培养物。检测无症状菌尿患者、有症状尿路感染患者和无菌尿患者（对照组）尿样中的白细胞介素（IL）-6和IL-8水平。在12个月的随访期间观察无症状菌尿患者和对照组血清肌酐水平的变化。
5例患者被诊断为尿路感染，22例患者为无症状菌尿。有症状尿路感染组尿IL-6水平显著更高（中位数15.71pg/mg），但无症状菌尿组（3.92pg/mg）和对照组（2.54pg/mg）之间无差异。有症状尿路感染组尿IL-8水平更高（中位数146.8pg/mg），与对照组（2.97pg/mg；P=0.0002）相比，无症状菌尿组也显著更高（33.49pg/mg）。在1年的随访期间，无症状菌尿组尿路感染的发生率高于对照组，但两组的移植肾功能无差异。
无症状菌尿的肾移植患者尿IL-8水平升高可能反映对细菌感染的免疫反应受损以及尿路隐匿性炎症过程。
