*Purpose: This study aims to examine the etiology of urinary tract infections (UTIs) in a cohort of KTxps, trying to identify their potential predisposing factors both during the first year and in the global follow-up (FU) of KTx, the impact of UTIs on KTx and patient’s survival.

*Methods: 585 KTxps were studied and followed up for a median time of 8yrs. Clinical and biochemical data about the 1st (T1) and the 12th month (T12) of KTx were collected. A number of UTIs ≥3 was considered significant during the 1st year of KTx and in the overall FU.

*Results: In the cohort males were 59% and the median age was 49yrs. At the time of KTx, JJ ureteral stent (JJ) was placed in 38% of KTxps. During the FU, 1700 UTIs were found in 458 KTxp, 550 UTIs during the first year of KTx. According to the number of UTIs found during the 1st year of KTx, KTxp were categorized in: UTI1≥3 (N=139) and UTI1<3 (N=446). UTI1≥3 were more frequently female and older, had more prevalence of JJ and ATG therapy, and lower hemoglobin and albumin at T1 and T12. The presence of JJ, female gender and induction therapy with ATG were the factors most correlated with IVU1≥3 (OR 1.9). The studied cohort was also categorized according to the number of UTIs during the FU in UTItot ≥3 (N=168) and UTItot<3 (N=417). UTI tot ≥3 were more frequently females, older, had a longer dialysis vintage and higher prevalence of JJ placement than UTI tot<3. They had significantly lower hemoglobin and serum albumin values, at T1 and T12. The presence of JJ, the female gender and age at KTx were the factors most related to UTItot ≥3 (OR 1.8). During the FU, the median absolute reduction in eGFR was -0.6[-2.0; +0.9](mL/min)/years. Despite a greater reduction in glomerular filtrate rate in UTI tot≥3 group, the graft loss and the death with functioning graft had no correlation with UTIs. Graft loss was observed in 51 KTxps. Also in this case, no statistical differences were found in survival analysis according to IVU tot≥3 category. During the global FU, 40 KTxp died with functioning graft. Also with regard to this outcome, no significant correlations were observed with the number of UTIs/follow-up time and in the survival analysis.

*Conclusions: Our data confirm that UTIs are frequent in KTxps. Some factors, such as induction therapy and JJ use, certainly have a favoring effect in UTIs development. UTIs had no significant impact on graft loss. Beyond prevention through the improvement of lifestyles and various behavioral aspects, the implementation of personalized immunosuppressive protocols associated with a careful management of JJ are desirable interventions in order to prevent the development of UTIs in KTxps.

« Back to 2022 American Transplant Congress