Diarrhea in kidney transplant recipients: Etiology and outcome

• Published in: Indian journal of gastroenterology 2020-04, Vol.39 (2), p.141-146
• Main Authors: Sonambekar, Ajinkya, Mehta, Vatsal, Desai, Devendra, Abraham, Philip, Almeida, Alan, Joshi, Anand, Gupta, Tarun, Sirsat, Rasika, Kothari, Jatin
• Format: Article
• Language: English
• Subjects: Gastroenterology; Hepatology; Medicine; Medicine & Public Health; Original Article
• ISSN: 0254-8860; 0975-0711
• DOI: 10.1007/s12664-020-01022-1

Background and Aim Diarrhea in kidney transplant recipients influences outcome of transplantation. Data from India in this regard are sparse and do not address the differential outcome of infective and non-infective diarrhea. We studied the demographic data, laboratory findings, treatment response, disease duration, and outcome of diarrhea in kidney transplant recipients, and the differential outcome between infective and non-infective diarrhea, if any. Methods All kidney transplant recipients who were referred to the Division of Gastroenterology with diarrhea between June 2015 and February 2017 were prospectively included. Demographic, clinical and laboratory data, graft function, treatment administered, and outcome were noted, and the patients were followed up for 3 months. Results Forty-seven patients (median age 45 years, range 16–78; 34 men) with 64 episodes of diarrhea were studied. Thirty-three (51.5%) episodes were attributed to infections. Eleven (17%) were immunosuppressant-induced (mycophenolate 8, tacrolimus 2, cyclosporine 1). Twenty (31%) were due to other causes (antibiotics 6, laxatives 3, irritable bowel syndrome 3, sepsis 8). Fifty - three episodes (82%) had graft dysfunction during the diarrheal episodes. Mean increase in serum creatinine was 45% in the infectious diarrhea group and 95% in the non-infectious diarrhea group ( p