Urinary tract infections in renal transplant recipients : a single center study

Abstract EN

Objective: To determine the types and frequency of urinary tract infections among renal transplant recipients.

Methods: A total of 83 renal transplant recipients who attended the Nephrology out patient clinic at King Hussein Medical Center, during the two months of study period (September-November, 2005) were included in the study.

Routine urine analysis and urine culture were performed in all patients.

The study group had normal kidney function and minimum period of four weeks post renal transplant.

Results: Fifty-six (67%) were males and 27 (33%) were females, their ages ranged between (16-60) years with a mean of 35.9 years.

The mean duration of transplantation was 26.4 months, and the mean serum creatinine was 1.14mg/dl.

The source of their grafts were living related donors in 71 recipients (85.5%) and living unrelated donors in 12 recipients (14.5%) and none were from deceased donors.

Seven recipients (8.4%) were on double immunosuppression therapy (calcineurin inhibitor and steroid) while 76 (91.6%) were on triple immunosuppression therapy.

The frequency of urinary tract infections was 28.9%.

Asymptomatic urinary tract infections occurred in 9.6%, however, symptomatic urinary tract infections occurred in 19.2%.

Females constituted 75% of the asymptomatic group, while males among the symptomatic group were 87.5%.

About two-thirds of isolated microorganisms were E.Coli (62.5%).

Males with renal transplants had higher frequency of symptomatic urinary tract infections, particularly if the graft was from living unrelated donor.

All patients with pre transplant vesicoureteric reflux had symptomatic post transplant urinary tract infections, despite pretransplant unilateral or bilateral nephro-ureterectomy for patients with grade IV vesicoureteric reflux.

Conclusion: Almost one-third of renal transplant recipients will develop urinary tract infections.

Vesicoureteric reflux should be treated before renal transplant.

Patients should be evaluated for urinary tract infections during routine out patient follow-up, particularly those with post transplant diabetes mellitus