Date: Sunday, May 3, 2015
Session Name: Poster Session B: Bacterial/Fungal/Other Infections
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Urinary tract infection (UTI) following renal transplantation remains the most common post transplant bacterial infection and appears to be closely linked to reduced allograft and patient survival. Some patients suffer multiple recurrent UTIs whereas others appear to be protected from developing UTIs after receiving a kidney transplant. Uromodulin (UMOD) is the most abundant urinary protein in humans and is excreted at the thick ascending limb of Henle's loop. The functional role of UMOD in human kidney disease is unclear, but it seems associated with innate immunity. UMOD knockout mice exhibit defects in clearing bacteria from the bladder. Moreover, UMOD blocks the colonization of urothelia by binding to E.coli fimbriae.
Patients and methods: In this study we measured urinary UMOD (uUMOD) concentrations and uUMOD/creatinine ratios in spot urine samples from renal transplant patients with recurrent UTIs (n=34) and without UTIs (n=40). Patient cohorts were matched for recipient age and sex as well as donor age.
Results: The uUMOD concentrations were significantly lower in the recurrent UTI group (7.41 pmol/ul ± 0.75) compared to the group of patients without UTIs (14.3pmol/ul ± 0.92) (p<0.001). Similarly, uUMOD/creatinine ratios in the recurrent UTI group were highly significant reduced (1236 ± 150) compared to the no UTI controls (2412 ± 246) (p<0.001). Both groups were treated with comparable immunosuppressive regimens, had similar deceased to living donor relations and CITs. Interestingly, the low uUMOD group showed significantly higher rates of initial graft non function (INF) (52.9% vs. 15%, p<0,001) and higher need for dialysis after NTX (52.9% vs. 20%, p=0.003). In addition overall kidney function was significantly reduced in this group (mean minimal creatinine 156.5umol/l vs. 127.5 umol/l, p=0.021).
Conclusion: Reduced uUMOD levels are closely linked to the risk of developing UTI after renal transplantation and are associated with a higher incidence of INF, the need for dialysis and overall graft function.
To cite this abstract in AMA style:Stahl K, Beneke J, Haller H, Gwinner W, Schiffer M. Reduced Urinary Uromodulin (UMOD)-Levels Are associated With Urinary Tract Infections (UTI) After Renal Transplantion [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/reduced-urinary-uromodulin-umod-levels-are-associated-with-urinary-tract-infections-uti-after-renal-transplantion/. Accessed July 15, 2020.
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