The treatment of AB in KT recipients is controversial. To the very best of our knowledge this is the first prospective study about this issue.
We prospectively included 63 patients who developed an episode of AB at least 2 months after kidney transplantation, from January 2011 to August 2012. We randomly assigned them to group A, in which all episodes of AB were systematically searched and treated, and group B, in which episodes of AB were not treated. During the first 2 months after transplantation AB was treated in both groups. The primary study outcome was the incidence of pyelonephritis (PN) during follow-up. Secondary outcomes included incidence of acute rejection and long-term graft function. We compared both groups using X^2 for qualitative variables and Student´s t test for quantitative variables.
Twenty-eight patients were assigned to group A and 35 to group B. There were no differences in their basal characteristics (gender, age, prevalence of diabetes mellitus, cause of transplantation, type of donor, immunosuppresive regimen, length of urinary tract catheterization and surgery complications). Mean follow up was similar in both groups (overall 326.5 days). Two patients (7.1%) in group A and 4 patients (11.4%) in group B developed PN during the follow-up (p=0.68). Both episodes of PN in group A could be attributed to failures in the application of the strategy (one patient developed AB that was not treated just before PN; the other had been treated for cystitis without post-treatment urine culture and developed PN). The mean time between the episode of AB and the onset of PN was 4.8 days. The mean number of AB was lower in group A (2.5 ± 2 vs 3.6 ± 2.7; p=0.06). There were no differences in graft function at the end of follow-up (MDRD 47.9 ± 17.6 mL/min in group A vs 48.2 ± 16.4 mL/min in group B; p=0.93). The incidence of rejection was numerically lower in group A than in group B (7.1% vs. 11.4%; p=0.68).
Although the difference is not significant, there is a trend to a lower incidence of PN in KT recipients in which AB is systematically searched and treated. These preliminary results need to be confirmed once we reach the established sample size.
To cite this abstract in AMA style:Origüen J, López-Medrano F, Pérez-Jacoiste M, García-Reyne A, Fernández-Ruiz M, Carrasco N, Silva T, Morales J, Andrés A, Aguado J. Prospective Comparative Study of a Strategy of Systematic Search and Treatment Versus No Treatment of Asymptomatic Bacteriuria (AB) in Kidney Transplant (KT) Recipients: Preliminary Results [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/prospective-comparative-study-of-a-strategy-of-systematic-search-and-treatment-versus-no-treatment-of-asymptomatic-bacteriuria-ab-in-kidney-transplant-kt-recipients-preliminary-results/. Accessed October 26, 2020.
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