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肾移植后感染的发生率和危险因素。

Incidence and risk factors of infections following kidney transplantation.

机构信息

Umm Al-Qura University, Pharmacy Practices Department, College of Pharmacy, Makkah, Saudi Arabia.

出版信息

J Infect Public Health. 2024 Aug;17(8):102491. doi: 10.1016/j.jiph.2024.102491. Epub 2024 Jul 2.

Abstract

BACKGROUND

For patients with End-Stage Renal Disease (ESRD), kidney transplantation stands as the superior alternative to dialysis, exhibiting enhancements in both quality of life and survival rates. The objective of this study is to ascertain the prevalence of infections and associated risk factors within the initial two years post-renal transplant.

METHOD

A retrospective study of all renal transplant recipients who underwent renal transplantation at king Abdullah medical city in Makkah, Saudi Arabia from January 1st, 2018, till end of December 2021 followed up for two years.

RESULTS

A total of 43 patients were included in the study, The participants who experienced infectious episodes had a higher mean age, averaging 45.26 ± 14, in contrast to those who did not, averaging 38.75 ± 12. Most of the patients included in the study were male, 70 % of the total population. However, most infectious complications occurred in women (77 % vs. 30 %, respectively, p-value 0.004). Regarding the mode of dialysis before the transplantation, most of the patients were maintained on hemodialysis (76.7 %), and the mean duration of dialysis was longer on those presented with infections within two years post-transplant compared to those without it (3.26 ± 1.6 vs. 2 ± 1.14 years respectively). The incidence of the infections was 44.2 % (19 individuals). The most common presented infections in the patients within two years post renal transplant were urinary tract infections (20.9 %), with a high recurrence rate reaching 11.6 %. This was followed by Coronavirus disease (COVID-19) and Cytomegalovirus (CMV).

CONCLUSION

This study sheds light on the prevalence of infectious complications following renal transplantation and highlights specific risk factors associated with these infections. Understanding these patterns can aid in the development of preventive strategies and optimized care for transplant recipients during the early post-transplant period.

摘要

背景

对于终末期肾病(ESRD)患者来说,肾移植是优于透析的选择,能提高生活质量和存活率。本研究旨在确定肾移植后最初两年内感染的流行情况和相关危险因素。

方法

这是一项回顾性研究,纳入了 2018 年 1 月 1 日至 2021 年 12 月 31 日期间在沙特阿拉伯麦加阿卜杜拉国王医学城接受肾移植的所有肾移植受者,并对他们进行了两年的随访。

结果

本研究共纳入 43 例患者,发生感染的患者平均年龄为 45.26 ± 14 岁,高于未发生感染的患者(38.75 ± 12 岁)。研究中大多数患者为男性(占总人群的 70%),但大多数感染性并发症发生在女性(分别为 77%和 30%,p 值=0.004)。关于移植前的透析方式,大多数患者接受血液透析(76.7%),与未发生感染的患者相比,在移植后两年内发生感染的患者的透析时间更长(分别为 3.26 ± 1.6 年和 2 ± 1.14 年)。感染发生率为 44.2%(19 例)。肾移植后两年内患者最常见的感染是尿路感染(20.9%),复发率高达 11.6%。其次是冠状病毒病(COVID-19)和巨细胞病毒(CMV)。

结论

本研究阐明了肾移植后感染性并发症的流行情况,并强调了与这些感染相关的特定危险因素。了解这些模式有助于制定预防策略,并优化移植后早期接受者的护理。

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