Urinary tract infection in patients after renal transplantation: evaluation of risk factors

Background: Kidney transplantation is currently the best method of renal replacement therapy in patients with chronic renal failure. A common complication in renal transplantation patients is urinary tract infection (UTI). We assessed UTI risk factors in kidney recipients from deceased donors and its impact on graft function and survival. Material and Methods: Retrospective analysis was applied to a group of 220 patients who underwent the transplant procedure in 2010 and 2011. Patients were divided into two groups: patients diagnosed with UTI in the first month post-transplant (n=55) and patients without UTI (n=165). Results: Statistically significant risk factors for increased UTI included receiving a kidney from a donor with expanded criteria, lower flow in the fourth hour of mechanical perfusion (<120 ml/min), lower HLA compatibility (>4 mismatches), operation time (<200 min), the occurrence of delayed graft function, post-transplantation diabetes mellitus, and urological complications after transplantation. Patients with UTI experienced a significantly prolonged hospital stay (28 days vs. 15 days, p=0.01). Factors such as gender, age, body mass index, duration of dialysis in the recipient, length of surgery, type of immunosuppression used, and one-year graft survival rates did not differ between the two groups. Conclusions: ECD donor, 4 and more mismatches in HLA compatibility, long surgery time and lack of IGF are the predicting pre-transplant factors of UTI. Analyzing known risk factors before transplantation, (with reference to factors possible to occur after Tx) could determine how UTI prophylaxis is to be administered.