Korean J Nephrol.
2009 Jul;28(4):310-316.
Acute Graft Pyelonephritis after Kidney Transplantation: Clinical Manifestations and the Impact on Long-term Allograft Outcome
- Affiliations
-
- 1Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea. hayoung.oh@samsung.com
- 2Department of Internal Medicine, Seoul Medical Center, Seoul, Korea.
- 3Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
- PURPOSE
The objective of this study was to investigate the clinical manifestations and risk factors associated with acute graft pyelonephritis (AGPN) and its impact on graft outcome.
METHODS
We performed a retrospective study reviewing the medical records of 272 recipients with a graft survival of more than 1 year among 291 recipients that had undergone kidney transplantation between January 1995 and December 1999.
RESULTS
Twenty eight (10.3%) patients had at least one episode of AGPN during a follow-up of 7.3 years, and 14 (50%) among them had recurrent episodes. 31.5% of total AGPN episodes had no any urinary signs and symptoms and only had a fever and leukocyturia. Escherichia coli and Klebsiella, the most common pathogens isolated, were susceptible to ciprofloxacin in 48.6% of cases and to ceftriaxone in 94.3% of cases. Acute rejection was not associated with the occurrence of AGPN. However, female gender was a risk factor for acute rejection (risk ratio 7.11, p<0.001). Vesicoureteral reflux in allograft was found in 72.7% of the recipients with an episode of AGPN (16/22). There was a trend toward more frequent development of vesicoureteral reflux in recipients with recurrent AGPN episodes (54.6% in patients with a single episode vs 90.9% in patients with recurrent episodes, p= 0.074). On Cox regression/Time-dependent covariate analysis, AGPN had no significant association with the graft or patient survival.
CONCLUSION
AGPN is common after kidney transplantation, especially in women. However, AGPN was not associated with a poor long-term graft outcome.
MeSH Terms
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Impact of the Pattern of Acute Rejection Episodes on Graft Survival
- Acute Allograft Pyelonephritis Following Renal Transplantation
- Factors Predicting Long-term Graft Survival after Kidney Transplantation
- The Impact of Acute Rejection on Long-Term Graft Outcome in Renal Allograft Recipient
- Long term clinical benefits of pancreas-transplantation after kidney transplantation in patients with diabetes who had received kidney transplantation
