Incidence, Risk Factors, and Outcomes of Hospitalized Urinary Tract Infections in Kidney Transplant Recipients
Multi-Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
Meeting: 2015 American Transplant Congress
Abstract number: A75
Keywords: Infection, Kidney transplantation
Session Information
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Background: Urinary tract infections (UTIs) are common complications in kidney transplant recipients (KTRs) due to their immunocompromised state. Severe infections often lead to hospitalizations and may lead to poor patient outcomes. This study investigated the incidence, risk factors, and impact of hospitalized UTIs on graft and patient outcomes in KTRs.
Methods: This retrospective cohort study examined 1,091 patients who received a kidney transplant between 1 July 2004 and 31 December 2012 with at least one-year of follow-up. A hospitalized UTI was defined as a symptomatic UTI (>105 colony forming units/mL of urine) requiring inpatient management. The cumulative probability of hospitalized UTIs was assessed using Kaplan-Meier survival curves and the difference between groups was examined using the log rank test. Potential risk factors for hospitalized UTIs and adverse patient outcomes were analyzed using a time-dependent multivariable Cox proportional hazards models.
Results: There were a total of 103 hospitalized UTI events accrued over 4302.2 person-years of follow-up. The cumulative probability of hospitalized UTI was 11.4% at 6 years post-transplant. As observed in time-dependent multivariable Cox proportional hazards models, a previous non-hospitalized UTI (HR 1.81 [95% CI: 1.14, 2.87]), female sex (HR 2.07 [95% CI: 1.32, 3.22]) and time on dialysis before transplant (HR 1.08 per year [95% CI, 1.01, 1.16]) were significantly associated with an elevated risk of developing a hospitalized UTI. Receiving a transplant in the most recent era (i.e., 2008 to 2010) was protective (HR 0.45 [95% CI 0.26, 0.76]). There was no significant association between the occurrence of a hospitalized UTI and acute rejection, death-censored graft failure, death with graft function, or total graft failure.
Conclusion: Our results suggest that a previous non-hospitalized UTI event, female sex and prolonged time on dialysis independently predict the occurrence of a hospitalized UTI in KTRs. Hospitalized UTIs did not appear to have adverse long-term implications for the graft or patient but corroboration of these findings in a larger cohort with longer term follow-up is warranted.
To cite this abstract in AMA style:
Pang H, Liang C, Famure O, Li Y, Kim J. Incidence, Risk Factors, and Outcomes of Hospitalized Urinary Tract Infections in Kidney Transplant Recipients [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/incidence-risk-factors-and-outcomes-of-hospitalized-urinary-tract-infections-in-kidney-transplant-recipients/. Accessed May 19, 2025.« Back to 2015 American Transplant Congress