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肾移植受者尿路感染的患病率及危险因素:一项荟萃分析研究。

Prevalence and risk factors of urinary tract infection in kidney recipients: a meta-analysis study.

机构信息

Faculty of Medical Sciences, Tabriz Branch, Islamic Azad University, Tabriz, Iran.

Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, 83153-45139, IR, Iran.

出版信息

BMC Nephrol. 2023 Sep 27;24(1):284. doi: 10.1186/s12882-023-03338-4.

Abstract

BACKGROUND

A kidney recipient's urinary tract infection (UTI) can result in infectious problems and be a risk factor for less successful transplant outcomes. UTI risk factors are still controversial. The present study aimed to investigate the prevalence of UTI and its association with risk factors in kidney recipients.

METHOD

Twenty-six papers published between 2005 and 2022 were retrieved using keywords and searching Medlib, ScienceDirect, PubMed, and other databases. If possible, the pooled prevalence of UTI in kidney recipients and odds ratio (OR) with a 95% confidence interval for each risk factor were calculated. The data were analyzed using the random effects model in R and Stata 14.

RESULTS

The total sample size was 72,600, with an average age of 48.7 years. The pooled prevalence of UTI was 35% (95% CI, 30-40%). The estimated risk factors for UTI were female (OR = 3.13; 95%CI: 2.35-4.17), older age (OR = 1.03; 95%CI: 1-1.05), history of UTI (OR = 1.31; 95%CI) CI: 1.05-1.63), receiving a kidney from a deceased donor (OR = 1.59; 95%CI: 1.23-2.35), long-term use of an indwelling catheter (OR = 3.03; 95%CI: 1.59-6.59), a ureteral stent (OR = 1.54; 95%CI: 1.16-2.06), diabetes (OR = 1.17; 95%CI: 0.97-1.41), hypertension (OR = 1.6; 95%CI: 1.26-2.28), acute rejection process (OR = 2.22; 95%CI: 1.45-3.4), and abnormal urinary tract anatomy (OR = 2.87; 95%CI 1.44-5.74).

CONCLUSION

This meta-analysis revealed that UTIs are a significant problem in kidney recipients. Factors such as female sex, old age, history of UTIs, deceased donor, long-term use of an indwelling catheter, diabetes, acute rejection process, use of ureteral stent, abnormal urinary tract anatomy, and hypertension were related to an increased risk of UTIs in kidney recipients.

摘要

背景

肾脏受者的尿路感染(UTI)可导致感染问题,并成为移植结局不成功的风险因素。UTI 的风险因素仍存在争议。本研究旨在调查肾脏受者 UTI 的患病率及其与危险因素的关系。

方法

使用关键词检索 Medlib、ScienceDirect、PubMed 等数据库,检索了 2005 年至 2022 年间发表的 26 篇论文。如果可能,计算了肾脏受者 UTI 的总患病率和每个危险因素的比值比(OR)及其 95%置信区间。使用 R 和 Stata 14 中的随机效应模型分析数据。

结果

总样本量为 72600 例,平均年龄为 48.7 岁。UTI 的总患病率为 35%(95%CI,30-40%)。UTI 的估计危险因素包括女性(OR=3.13;95%CI:2.35-4.17)、年龄较大(OR=1.03;95%CI:1-1.05)、UTI 病史(OR=1.31;95%CI:1.05-1.63)、接受已故供者的肾脏(OR=1.59;95%CI:1.23-2.35)、长期留置导尿管(OR=3.03;95%CI:1.59-6.59)、输尿管支架(OR=1.54;95%CI:1.16-2.06)、糖尿病(OR=1.17;95%CI:0.97-1.41)、高血压(OR=1.6;95%CI:1.26-2.28)、急性排斥反应过程(OR=2.22;95%CI:1.45-3.4)和异常的尿路解剖结构(OR=2.87;95%CI 1.44-5.74)。

结论

这项荟萃分析表明,UTI 是肾脏受者的一个严重问题。女性、年龄较大、UTI 病史、已故供者、长期留置导尿管、糖尿病、急性排斥反应过程、使用输尿管支架、异常尿路解剖结构和高血压等因素与肾脏受者 UTI 风险增加有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b94/10523791/94242b59c0c1/12882_2023_3338_Fig1_HTML.jpg

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