Background: Urinary tracts infections (UTIs) are the most common infectious complications following renal transplantation (RT). The aim of this study was to evaluate the frequency and risk factors for UTIs during the first year after RT, and to develop nomograms to predict these infections.

Methods: We performed a retrospective observational study of adult RT patients at the Regional University Hospital between January 2012 and July 2014. We analyzed clinical data and urine cultures performed during the first year after RT.

Results: We studied data from 322 RT recipients, 66.1% men, with mean age of 52.2 ± 13.2 years. We observed 385 UTI episodes in 149 patients during the first year after RT and 12 cases of urosepsis. By Cox regression, recipient age, recipient gender and time on dialysis before RT were significantly associated with UTIs globally during the first 12 months after RT (HR 1.02, 95% confidence interval (CI), 1 – 1.03, p = 0.01; HR 1.79, CI 1.29 – 2.48, p = 0.001; HR 1, CI 0.99 – 1.01, p = 0.054, respectively). Also, recipient age, recipient gender, previous UTI and time on dialysis before RT were significantly associated with UTIs within 30 days after RT (HR 1.02, CI 1 – 1.03, p = 0.01; HR 2.17, CI 1.48 – 3.17, p = 0.001, HR 2.71, CI 1.83 – 4.02, p = 0.001, HR 1, CI 0.99 – 1.01, p = 0.32, respectively). By logistic regression analysis, the most important risk factors for UTI during RT hospitalization were donor age, indwelling bladder catheter > 7 days, time on dialysis before RT and delayed graft function (DGF) (OR 1.03, CI 1 – 1.05, p = 0.05; OR 3.55, CI 1.85 – 6.93, p = 0.001; OR 1.01, CI 1 – 1.02, p = 0.13; OR 2.64, CI 1.33 – 5.28, p = 0.01). We developed nomograms for each period (UTIs during the first year, during hospitalization, and 30 days after RT). The respective areas under the ROC curve were 0.60, 0.74, and 0.66.

Conclusions: The incidence of UTIs during the first year after RT in this study was high (46.3%). The most significant risk factors for UTI were recipient and donor age, recipient gender, previous UTI, time on dialysis before RT, bladder catheter duration > 7 days, and DGF. Awareness of these nomograms could help prevent UTIs.

CITATION INFORMATION: Jironda C, López V, Cabello M, Duarte A, Gutiérrez C, Ruiz P, Burgos D, Hernández D. Urinary Tract Infections During the First Year After Renal Transplantation: Risk Factors and Nomograms. Am J Transplant. 2016;16 (suppl 3).

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