Acute graft pyelonephritis in renal transplant recipients: incidence, risk factors and long-term outcome
The influence of acute graft pyelonephritis (AGPN) on graft outcome in renal transplant recipients still remains controversial. We retrospectively analysed 189 patients (113 males; mean age: 49.7 ± 13.1 years) undergoing renal transplantation at the University Hospital 12 de Octubre (Madrid, Spain)...
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| Veröffentlicht in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2011-03, Vol.26 (3), p.1065-1073 |
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| creator | FIORANTE, Silvana FERNANDEZ-RUIZ, Mario LOPEZ-MEDRANO, Francisco LIZASOAIN, Manuel LALUEZA, Antonio MORALES, Jose Maria SAN-JUAN, Rafael ANDRES, Amado OTERO, Joaquin R AGUADO, Jose Maria |
| description | The influence of acute graft pyelonephritis (AGPN) on graft outcome in renal transplant recipients still remains controversial.
We retrospectively analysed 189 patients (113 males; mean age: 49.7 ± 13.1 years) undergoing renal transplantation at the University Hospital 12 de Octubre (Madrid, Spain) from January 2002 to December 2004, with a minimum follow-up of 36 months. Factors associated with AGPN were assessed by logistic regression analysis. Long-term graft function was compared according to the occurrence of this complication during follow-up. 'Decline in renal graft function' was defined as the increase in serum creatinine (SC) levels > 0.33 mg/dL between Month 3 and Year 1 after transplantation.
Nineteen patients (10.0%) were diagnosed with 25 episodes of AGPN (incidence rate: 4.4 episodes per 100 patient-years). The presence of glomerulonephritis as the underlying disease [odds ratio (OR) 4.2; 95% confidence interval (95%CI): 1.3-14.1] and the previous occurrence of two to five (OR 9.4; 95%CI: 1.5-56.8) or more than five episodes of asymptomatic bacteriuria after transplantation (OR 19.8; 95%CI: 2.4-160.2) emerged as independent predictors for AGPN. A near-significant association was found for cytomegalovirus infection (OR 4.2; 95%CI: 0.9-18.4), whereas receiving a single-kidney transplant (vs. double-kidney) showed a protective effect (OR 0.2; 95%CI: 0.0-0.8). During the 36-month follow-up, levels of SC, creatinine clearance and 24-h proteinuria did not differ significantly between patients with or without AGPN, and this complication did not exert any effect on the risk for decline in renal graft function.
AGPN does not impair long-term graft function in renal transplant recipients. |
| doi_str_mv | 10.1093/ndt/gfq531 |
| format | Article |
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We retrospectively analysed 189 patients (113 males; mean age: 49.7 ± 13.1 years) undergoing renal transplantation at the University Hospital 12 de Octubre (Madrid, Spain) from January 2002 to December 2004, with a minimum follow-up of 36 months. Factors associated with AGPN were assessed by logistic regression analysis. Long-term graft function was compared according to the occurrence of this complication during follow-up. 'Decline in renal graft function' was defined as the increase in serum creatinine (SC) levels > 0.33 mg/dL between Month 3 and Year 1 after transplantation.
Nineteen patients (10.0%) were diagnosed with 25 episodes of AGPN (incidence rate: 4.4 episodes per 100 patient-years). The presence of glomerulonephritis as the underlying disease [odds ratio (OR) 4.2; 95% confidence interval (95%CI): 1.3-14.1] and the previous occurrence of two to five (OR 9.4; 95%CI: 1.5-56.8) or more than five episodes of asymptomatic bacteriuria after transplantation (OR 19.8; 95%CI: 2.4-160.2) emerged as independent predictors for AGPN. A near-significant association was found for cytomegalovirus infection (OR 4.2; 95%CI: 0.9-18.4), whereas receiving a single-kidney transplant (vs. double-kidney) showed a protective effect (OR 0.2; 95%CI: 0.0-0.8). During the 36-month follow-up, levels of SC, creatinine clearance and 24-h proteinuria did not differ significantly between patients with or without AGPN, and this complication did not exert any effect on the risk for decline in renal graft function.
AGPN does not impair long-term graft function in renal transplant recipients.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfq531</identifier><identifier>PMID: 20805254</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Acute Disease ; Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cohort Studies ; Creatinine - blood ; Emergency and intensive care: renal failure. Dialysis management ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Graft Rejection - etiology ; Graft Survival ; Humans ; Incidence ; Intensive care medicine ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - surgery ; Kidney Function Tests ; Kidney Transplantation - adverse effects ; Male ; Medical sciences ; Middle Aged ; Postoperative Complications ; Pyelonephritis - etiology ; Retrospective Studies ; Risk Factors ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Survival Rate ; Treatment Outcome</subject><ispartof>Nephrology, dialysis, transplantation, 2011-03, Vol.26 (3), p.1065-1073</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c382t-b3935b18acfb5baee6678666d509735babefe2405899fc18856f3aea97aafc643</citedby><cites>FETCH-LOGICAL-c382t-b3935b18acfb5baee6678666d509735babefe2405899fc18856f3aea97aafc643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23952156$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20805254$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>FIORANTE, Silvana</creatorcontrib><creatorcontrib>FERNANDEZ-RUIZ, Mario</creatorcontrib><creatorcontrib>LOPEZ-MEDRANO, Francisco</creatorcontrib><creatorcontrib>LIZASOAIN, Manuel</creatorcontrib><creatorcontrib>LALUEZA, Antonio</creatorcontrib><creatorcontrib>MORALES, Jose Maria</creatorcontrib><creatorcontrib>SAN-JUAN, Rafael</creatorcontrib><creatorcontrib>ANDRES, Amado</creatorcontrib><creatorcontrib>OTERO, Joaquin R</creatorcontrib><creatorcontrib>AGUADO, Jose Maria</creatorcontrib><title>Acute graft pyelonephritis in renal transplant recipients: incidence, risk factors and long-term outcome</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><description>The influence of acute graft pyelonephritis (AGPN) on graft outcome in renal transplant recipients still remains controversial.
We retrospectively analysed 189 patients (113 males; mean age: 49.7 ± 13.1 years) undergoing renal transplantation at the University Hospital 12 de Octubre (Madrid, Spain) from January 2002 to December 2004, with a minimum follow-up of 36 months. Factors associated with AGPN were assessed by logistic regression analysis. Long-term graft function was compared according to the occurrence of this complication during follow-up. 'Decline in renal graft function' was defined as the increase in serum creatinine (SC) levels > 0.33 mg/dL between Month 3 and Year 1 after transplantation.
Nineteen patients (10.0%) were diagnosed with 25 episodes of AGPN (incidence rate: 4.4 episodes per 100 patient-years). The presence of glomerulonephritis as the underlying disease [odds ratio (OR) 4.2; 95% confidence interval (95%CI): 1.3-14.1] and the previous occurrence of two to five (OR 9.4; 95%CI: 1.5-56.8) or more than five episodes of asymptomatic bacteriuria after transplantation (OR 19.8; 95%CI: 2.4-160.2) emerged as independent predictors for AGPN. A near-significant association was found for cytomegalovirus infection (OR 4.2; 95%CI: 0.9-18.4), whereas receiving a single-kidney transplant (vs. double-kidney) showed a protective effect (OR 0.2; 95%CI: 0.0-0.8). During the 36-month follow-up, levels of SC, creatinine clearance and 24-h proteinuria did not differ significantly between patients with or without AGPN, and this complication did not exert any effect on the risk for decline in renal graft function.
AGPN does not impair long-term graft function in renal transplant recipients.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Creatinine - blood</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glomerular Filtration Rate</subject><subject>Graft Rejection - etiology</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Incidence</subject><subject>Intensive care medicine</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - surgery</subject><subject>Kidney Function Tests</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Postoperative Complications</subject><subject>Pyelonephritis - etiology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE1L7DAUhoNc0fFj4w-QbC6CWE2aSZq6k8EvENzoupymJ2O0TWuSLvz3Rma8dxU478N7ch5CTji75KwWV75LV2v7KQXfIQu-VKwohZZ_yCKHvGCS1fvkIMZ3xlhdVtUe2S-ZZrKUywV5uzFzQroOYBOdvrAfPU5vwSUXqfM0oIeepgA-Tj34lAfGTQ59itc5N65Db_CCBhc_qAWTxhAp-I7mnnWRMAx0nJMZBzwiuxb6iMfb95C83t2-rB6Kp-f7x9XNU2GELlPRilrIlmswtpUtICpVaaVUl6-ocgItWiyXTOq6toZrLZUVgFBXANaopTgkZ5veKYyfM8bUDC4a7PPvcZxjo6VQVd7xQ55vSBPGGAPaZgpugPDVcNb8iG2y2GYjNsOn29q5HbD7h_6azMDfLQDRQG-zMuPif07UsuRSiW94aoPe</recordid><startdate>20110301</startdate><enddate>20110301</enddate><creator>FIORANTE, Silvana</creator><creator>FERNANDEZ-RUIZ, Mario</creator><creator>LOPEZ-MEDRANO, Francisco</creator><creator>LIZASOAIN, Manuel</creator><creator>LALUEZA, Antonio</creator><creator>MORALES, Jose Maria</creator><creator>SAN-JUAN, Rafael</creator><creator>ANDRES, Amado</creator><creator>OTERO, Joaquin R</creator><creator>AGUADO, Jose Maria</creator><general>Oxford University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110301</creationdate><title>Acute graft pyelonephritis in renal transplant recipients: incidence, risk factors and long-term outcome</title><author>FIORANTE, Silvana ; FERNANDEZ-RUIZ, Mario ; LOPEZ-MEDRANO, Francisco ; LIZASOAIN, Manuel ; LALUEZA, Antonio ; MORALES, Jose Maria ; SAN-JUAN, Rafael ; ANDRES, Amado ; OTERO, Joaquin R ; AGUADO, Jose Maria</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c382t-b3935b18acfb5baee6678666d509735babefe2405899fc18856f3aea97aafc643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Creatinine - blood</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glomerular Filtration Rate</topic><topic>Graft Rejection - etiology</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Incidence</topic><topic>Intensive care medicine</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - surgery</topic><topic>Kidney Function Tests</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Postoperative Complications</topic><topic>Pyelonephritis - etiology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surgery (general aspects). 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Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>FIORANTE, Silvana</creatorcontrib><creatorcontrib>FERNANDEZ-RUIZ, Mario</creatorcontrib><creatorcontrib>LOPEZ-MEDRANO, Francisco</creatorcontrib><creatorcontrib>LIZASOAIN, Manuel</creatorcontrib><creatorcontrib>LALUEZA, Antonio</creatorcontrib><creatorcontrib>MORALES, Jose Maria</creatorcontrib><creatorcontrib>SAN-JUAN, Rafael</creatorcontrib><creatorcontrib>ANDRES, Amado</creatorcontrib><creatorcontrib>OTERO, Joaquin R</creatorcontrib><creatorcontrib>AGUADO, Jose Maria</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>FIORANTE, Silvana</au><au>FERNANDEZ-RUIZ, Mario</au><au>LOPEZ-MEDRANO, Francisco</au><au>LIZASOAIN, Manuel</au><au>LALUEZA, Antonio</au><au>MORALES, Jose Maria</au><au>SAN-JUAN, Rafael</au><au>ANDRES, Amado</au><au>OTERO, Joaquin R</au><au>AGUADO, Jose Maria</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute graft pyelonephritis in renal transplant recipients: incidence, risk factors and long-term outcome</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol Dial Transplant</addtitle><date>2011-03-01</date><risdate>2011</risdate><volume>26</volume><issue>3</issue><spage>1065</spage><epage>1073</epage><pages>1065-1073</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract>The influence of acute graft pyelonephritis (AGPN) on graft outcome in renal transplant recipients still remains controversial.
We retrospectively analysed 189 patients (113 males; mean age: 49.7 ± 13.1 years) undergoing renal transplantation at the University Hospital 12 de Octubre (Madrid, Spain) from January 2002 to December 2004, with a minimum follow-up of 36 months. Factors associated with AGPN were assessed by logistic regression analysis. Long-term graft function was compared according to the occurrence of this complication during follow-up. 'Decline in renal graft function' was defined as the increase in serum creatinine (SC) levels > 0.33 mg/dL between Month 3 and Year 1 after transplantation.
Nineteen patients (10.0%) were diagnosed with 25 episodes of AGPN (incidence rate: 4.4 episodes per 100 patient-years). The presence of glomerulonephritis as the underlying disease [odds ratio (OR) 4.2; 95% confidence interval (95%CI): 1.3-14.1] and the previous occurrence of two to five (OR 9.4; 95%CI: 1.5-56.8) or more than five episodes of asymptomatic bacteriuria after transplantation (OR 19.8; 95%CI: 2.4-160.2) emerged as independent predictors for AGPN. A near-significant association was found for cytomegalovirus infection (OR 4.2; 95%CI: 0.9-18.4), whereas receiving a single-kidney transplant (vs. double-kidney) showed a protective effect (OR 0.2; 95%CI: 0.0-0.8). During the 36-month follow-up, levels of SC, creatinine clearance and 24-h proteinuria did not differ significantly between patients with or without AGPN, and this complication did not exert any effect on the risk for decline in renal graft function.
AGPN does not impair long-term graft function in renal transplant recipients.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>20805254</pmid><doi>10.1093/ndt/gfq531</doi><tpages>9</tpages></addata></record> |
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| ispartof | Nephrology, dialysis, transplantation, 2011-03, Vol.26 (3), p.1065-1073 |
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| subjects | Acute Disease Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cohort Studies Creatinine - blood Emergency and intensive care: renal failure. Dialysis management Female Follow-Up Studies Glomerular Filtration Rate Graft Rejection - etiology Graft Survival Humans Incidence Intensive care medicine Kidney Failure, Chronic - complications Kidney Failure, Chronic - surgery Kidney Function Tests Kidney Transplantation - adverse effects Male Medical sciences Middle Aged Postoperative Complications Pyelonephritis - etiology Retrospective Studies Risk Factors Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Survival Rate Treatment Outcome |
| title | Acute graft pyelonephritis in renal transplant recipients: incidence, risk factors and long-term outcome |
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