2018
DOI: 10.1016/j.kint.2018.06.029
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Renal transplant recipients receiving loop diuretic therapy have increased urinary tract infection rate and altered medullary macrophage polarization marker expression

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Cited by 15 publications
(17 citation statements)
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“…However, these agents (empagliflozine and canagliflozine) have shown a low risk of UTI in KT recipients with no history of recurrent UTIs in a few small studies [29][30][31]. In addition, the use of loop diuretics in KT recipients has also been associated with an increased rate of UTI during 5 years after transplantation, with changes in macrophage marker ratio in the renal medulla and in the corticomedullary salt gradient, which may have an impact on the immune microenvironment of the graft and predispose it to UTIs [32] (Table 1). UTIs in KT recipients are most common during the first 6 months after transplant [33], which may be explained by the increase of the factors mentioned above, such as surgical injury, urinary tract catheterization, recent hospitalization, and an increased state of immunosuppression.…”
Section: Risk Factorsmentioning
confidence: 99%
“…However, these agents (empagliflozine and canagliflozine) have shown a low risk of UTI in KT recipients with no history of recurrent UTIs in a few small studies [29][30][31]. In addition, the use of loop diuretics in KT recipients has also been associated with an increased rate of UTI during 5 years after transplantation, with changes in macrophage marker ratio in the renal medulla and in the corticomedullary salt gradient, which may have an impact on the immune microenvironment of the graft and predispose it to UTIs [32] (Table 1). UTIs in KT recipients are most common during the first 6 months after transplant [33], which may be explained by the increase of the factors mentioned above, such as surgical injury, urinary tract catheterization, recent hospitalization, and an increased state of immunosuppression.…”
Section: Risk Factorsmentioning
confidence: 99%
“…In addition, there is no strong evidence showing an association between loop diuretic and improvement in initial or long-term graft function (139). On the other hand, loop diuretic use has been associated with increased risk of UTI during the first 5 years after kidney transplantation (140). This is because there use depletes medullary NaCl gradient (140), which is known to modulate the adaptive and innate immune response (141).…”
Section: Loop Diureticsmentioning
confidence: 99%
“…On the other hand, loop diuretic use has been associated with increased risk of UTI during the first 5 years after kidney transplantation (140). This is because there use depletes medullary NaCl gradient (140), which is known to modulate the adaptive and innate immune response (141). Renal medullary myeloid mononuclear cell phagocytes are classified as pro-inflammatory (M1) and reparative/profibrotic (M2) cells.…”
Section: Loop Diureticsmentioning
confidence: 99%
“…This in turn may either enhance or reduce the efficacy of the treatment or may cause some side effects. Interestingly, depletion of salt gradient within the kidney due to the administration of loop diuretics was recently shown to affect macrophage polarization in transplanted organs, which resulted in an increased risk of bacterial urinary tract infection [ 7 ]. On the other hand, recent studies in an animal model demonstrated that captopril may prevent the development of diabetic nephropathy by reducing the number of glomerular macrophages [ 8 ].…”
Section: Introductionmentioning
confidence: 99%