Rodríguez Sánchez Martha Patricia, Afanador Rubio Diana Carolina, Luna Isabel Moreno, García Padilla Paola Karina, Contreras Villamizar Kateir Mariel, González González Camilo Alberto, Patiño Trejos Juan Agustín
Department of Internal Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
Department of Internal Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
Transplant Proc. 2020 May;52(4):1173-1177. doi: 10.1016/j.transproceed.2020.01.066. Epub 2020 Mar 13.
Urinary tract infection (UTI) is the most common infectious complication after renal transplantation. It is uncertain whether the development of UTI has an impact on renal graft function. The objective of this study was to evaluate the effects of complicated and recurrent UTI on 2-year renal graft function.
This was a historical cohort study in renal transplantation patients in a kidney transplant center. All renal transplant recipients from June 2004 to September 2016 were included. A linear regression analysis was performed to study the association between the outcome (variation in estimated glomerular filtration rate [eGFR] by the Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI] equation between month 1 and month 24 post-transplant) and the UTI. The approval of the Ethics and Research Committee to carry out this study was obtained.
In total, 276 kidney transplants were performed during the observation period. Of the transplant patients, 193 (69.9%) did not develop a UTI and 83 (30.1%) presented at least 1 complicated UTI. Patients who presented at least 1 UTI had a variation in eGFR during the observation period of -12.6 mL/min/1.73 m (95% confidence interval [CI] -4.5 to -20.7 mL/min/1.73 m; P = .02), compared with those without a UTI. Said difference persisted in the adjusted model controlling for variables that have an impact on the eGFR. This difference was -10.7 mL/min/1.73 m (95% CI -3.1 to -18.2 mL/min/1.73 m; P = .006).
The findings suggest that the occurrence of complicated UTI has a negative impact on graft function and that prevention and monitoring of UTIs should be stepped up to avoid their deleterious effects on graft function.
尿路感染（UTI）是肾移植后最常见的感染性并发症。UTI的发生是否会对肾移植功能产生影响尚不确定。本研究的目的是评估复杂性和复发性UTI对肾移植2年功能的影响。
这是一项在肾脏移植中心对肾移植患者进行的历史性队列研究。纳入了2004年6月至2016年9月期间所有的肾移植受者。进行线性回归分析以研究结局（移植后第1个月至第24个月期间根据慢性肾脏病流行病学合作组织[CKD-EPI]方程估算的肾小球滤过率[eGFR]的变化）与UTI之间的关联。获得了伦理与研究委员会开展本研究的批准。
在观察期内共进行了276例肾移植手术。在移植患者中，193例（69.9%）未发生UTI，83例（30.1%）出现至少1次复杂性UTI。与未发生UTI的患者相比，出现至少1次UTI的患者在观察期内eGFR的变化为-12.6 mL/min/1.73 m（95%置信区间[CI] -4.5至-20.7 mL/min/1.73 m；P = .02）。在控制了对eGFR有影响的变量的校正模型中，上述差异仍然存在。该差异为-10.7 mL/min/1.73 m（95% CI -3.1至-18.2 mL/min/1.73 m；P = .006）。
研究结果表明，复杂性UTI的发生对移植肾功能有负面影响，应加强对UTI的预防和监测，以避免其对移植肾功能产生有害影响。
