Febrile urinary tract infection after pediatric kidney transplantation: a multicenter, prospective observational study

• Published in: Pediatric Nephrology 2016, Vol.31 (6), p.1021
• Main Authors: Weigel, Friederike, Lemke, Anja, Tonshoff, Burkhard, Pape, Lars, Fehrenbach, Henry, Henn, Michael, Hoppe, Bernd, Jungraithmayr, Therese, Konrad, Martin, Laube, Guido, Pohl, Martin, Seeman, Tomas, Staude, Hagen, Kemper, Markus J, John, Ulrike
• Format: Report
• Language: English
• Subjects: Care and treatment; Complications and side effects; Health aspects; Kidney transplantation; Pediatrics; Urinary tract infections
• ISSN: 0931-041X
• DOI: 10.1007/s00467-015-3292-2

Febrile urinary tract infections (fUTIs) are common after kidney transplantation (KTx); however, prospective data in a multicenter pediatric cohort are lacking. We designed a prospective registry to record data on fUTI before and after pediatric KTx. Ninety-eight children (58 boys and 40 girls) [less than or equal to] 18 years from 14 mid-European centers received a kidney transplant and completed a 2-year follow-up. Posttransplant, 38.7 % of patients had at least one fUTI compared with 21.4 % before KTx (p = 0.002). Before KTx, fUTI was more frequent in patients with congenital anomalies of kidneys and urinary tract (CAKUT) vs. patients without (38 % vs. 12 %; p = 0.005). After KTx, fUTI were equally frequent in both groups (48.7 % vs. 32.2 %; p = 0.14). First fUTI posttransplant occurred earlier in boys compared with girls: median range 4 vs. 13.5 years (p = 0.002). Graft function worsened (p < 0.001) during fUTI, but no difference was recorded after 2 years. At least one recurrence of fUTI was encountered in 58 %. This prospective study confirms a high incidence of fUTI after pediatric KTx, which is not restricted to patients with CAKUT; fUTIs have a negative impact on graft function during the infectious episode but not on 2-year graft outcome.