Lack of Impact of Acute Pyelonephritis on Kidney Graft Survival

Lapa, Juliana de Souza; Halpern, Márcia; Gouvêa, Érika Ferraz de; Lemos, Alberto dos Santos de; Gonçalves, Renato Torres; Santoro‐Lopes, Guilherme

doi:10.1016/j.transproceed.2020.02.023

Cited by 1 publication

(1 citation statement)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…UTIs include mainly presenting as cystitis and acute graft pyelonephritis (AGPN). AGPN occurs in 10 to 20% of kidney transplant patients during follow-up ( 2 , 3 ). This complication requires hospitalization for close monitoring with a risk of progression to bacteremia because UTIs are the most common source of bloodstream infection ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of Late and Recurrent Acute Graft Pyelonephritis on Long-Term Kidney Graft Outcomes

et al. 2022

View full text Add to dashboard Cite

BackgroundWhile Urinary tract infections are the most common infections in kidney transplant recipients, the impact of late acute graft pyelonephritis (AGPN) on graft outcomes remains unknown. Our study was performed to more precisely evaluate the long-term impact of AGPN.MethodsWe included 9052 kidney and combined kidney-pancreas recipients who underwent transplantation between 2008 and 2018 from a French multicenter cohort. The relationships between AGPN and patient and graft survival were analyzed with a time-dependent multivariate Cox model.ResultsThe cumulative incidence of AGPN was 20.9%. A first episode of early AGPN is associated with a non-significant increase in the risk of graft failure (hazard ratio [HR], 1.27; 95% confidence interval [95% CI], 0.90 to 1.79). Though, cumulative number of AGPN episodes (HR = 1.51; 95% CI, 0.89 to 2.57 for two episodes and HR = 2.08; 95% CI, 1.17 to 3.69 for three or more episodes) is associated with an increased risk of graft failure. In contrast, when the first episode of AGPN occurred late (i.e., 6 months post transplantation), the risk of graft failure is significantly increased (HR = 2.25; 95% CI, 1.65 to 3.07), and this risk remains relatively stable with the recurrence of late AGPN episodes. The onset of late AGPN were also associated with a higher risk of patient death. ConclusionThis analysis shows that late AGPN and recurrent AGPN are both risk factors for a poor long-term graft outcome and mortality. Late AGPN should not be considered benign infections in post-transplantation follow-up.

show abstract

Section: Introductionmentioning

confidence: 99%