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Objective: To determine the incidence of urinary tract infections in kidney transplant patients in our hospital, to identify the microbial pathogens, risk factors for urinary tract infection. Subject and method: Primary kidney transplant patients at 108 Military Central Hospital with full follow-up records in the first year were included in the study. Age, sex, cause of kidney failure, pre-transplantation treatment measures, post-transplantation immunosuppressive regimen were collected. Patient was followed and midstream urine was cultured monthly. Result: There were 94 kidney transplant patients included in our study. Seventy patients (74.5%) were male and 24 (25.5%) were female. One hundred and two episodes of urinary tract infections in 37 patients (39.4%) were reported. Sex (female) (p=0.003; 95% CI: 1.716-14.021), urologic complications (p=0.006, 95% CI: 0.001-0.320) were found as risk factors for UTI in the first year of transplantation. Escherichia coli and Klebsiella pneumoniae were the most frequently isolated pathogens. UTI had no negative impact on short-term graft survival. Conclusion: The results of our study showed a high incidence of UTI in kidney transplant recipients. Infection control methods should be used regularly during post-transplant therapy.

Background: Metabolic syndrome (MS) contributes to excess graft failure and poor survival of kidney recipients and, hence, becomes an important clinical target following kidney transplantation. This study aims to determine factors associated with increased risk of MS events in Vietnamese kidney transplant patients. Methods: We conducted a single-centre cohort study among 104 patients receiving a first kidney transplant at a hospital in Vietnam. MS was defined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III and diagnosed after 1-month to 1-year post-transplant. Multivariable Cox proportional hazards models were applied to detect potential risk factors for MS. Results: A total of 75 patients completed one-year follow up post-transplantation with 53.3% (n=40) presenting with MS. Mean age of patients was 41.9±11.6-year-old, and the average duration of renal replacement therapy was 27.9±41.1 months. Prevalence of overweight was 4.0%, 69.3% hypertension, 54.7% low HDL-C, 94.7% hypertriglyceridemia, and 89.3% had hyperglycemia. Patients with hyperglycemia and low HDL-C before the transplantation had a significantly higher risk for MS later (OR 4.74, respectively). In the multivariable Cox proportional hazards, BMI (HR 0.87, 95%CI 0.78 -0.97); serum calcium (HR 0.15, 95%CI 0.04 -0.56); serum albumin (HR 1.25, 95%CI 1.12 -1.40); triglyceride (HR 1.41 95%CI 1.07 -1.86); blood level of tacrolimus (HR1.15, 95%CI 1.06 -1.25); and mycophenolate mofetil (HR 1.003, 95%CI 1.002 -1.005) were associated with increased risk of MS. Conclusion: Our results suggest that the presence of low HDL-C and hyperglycemia before kidney transplantation, are independent risk factors for MS in Vietnamese kidney transplant patients. MS is associated with BMI, serum calcium, albumin, triglyceride, the high blood level of tacrolimus and dose of mycophenolate mofetil. Interventions aimed at improving these factors before and after the transplantation may reduce the incidence of metabolic syndrome.

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We conducted a survey on the status of patients after kidney transplantation infected with JC virus (JCV), at 108 Military Central Hospital (108MCH), Vietnam, combining research on the effects of JCV infection on transplanted kidney function and understanding the risk factors for JCV infection in kidney transplant recipients. Patients and Methods: A single-center cohort study was conducted in the period from March 2021 to July 2022, using a combination of retrospective and prospective methods, with longitudinal follow-up of 94 eligible kidney transplant patients who agreed to participate, at the Department of Nephrology and Dialysis, 108MCH, Vietnam. Patients undergo monthly health checks and have their blood and urine tested by a real-time PCR method, with TaqMan probes (BioRad, USA). If at least one of the two specimens (blood or urine sample) is positive for JCV (when JCV is quantified in blood or urine samples at >250 copies/mL), the patient is confirmed to have JCV infection in any part or tissue of the body. Factors of JCV infection, such as age, gender, donor source, and immunosuppressive therapy, along with demographic and clinical data and JCV infection status, were analyzed using multivariable Cox-regression analysis. The estimated glomerular filtration rate (eGFR) was selected as an indicator of kidney function, and the difference in eGFR between JCV-infected patients and non-infected patients was compared using the t-test. This study was approved by the Research Ethics Committee. Results: JCV was detected in 71.3% of kidney transplant patients. Differences in eGFR were observed between the JCV-infected and non-infected patient groups (64.47±25.70 and 70.89±28.80 mL/min/1.73 m 2 for each group; independent t-test; t=−6.079; p=0.00). Factors such as kidney donor (HR=0.086; 95% confidence interval [CI]: 0.008-0.936; p=0.04), tacrolimus trough level (HR=1.083; 95% CI: 1.069-1.097; p=0.00), mycophenolate dose (HR=1.002; 95% CI: 1.002-1.001; p=0.00) and prednisone dose (HR=1.001; 95% CI: 1.000-1.001; p=0.00) in the trio of immunosuppressants tacrolimus + mycophenolate mofetil (MMF) + prednisone (multivariable Cox-regression analysis) are potential risk factors for JCV infection in renal transplantation. JCV infection in kidney transplant patients lowers the eGFR, leading to decreased transplant kidney function (independent t-test, p=0.00). Conclusion:The level of JCV infection in kidney transplant patients in our study is quite high (71.3%). Using an immunosuppressive regimen that uses the trio of immunosuppressants tacrolimus + MMF + prednisone, and having a donor source element are potential risk factors for JCV infection in renal transplantation. The function of the transplanted kidney is reduced by JCV infection in kidney transplant patients in the short term. The timely diagnosis and treatment of JCV can ensure the stable and long-term function of transplanted kidneys in kidney transplant patients.