Impact of Urinary Tract Infections and Cytomegalovirus Infections on Long-Term Renal Graft Function

Abstract

Background: Infections still frequently complicate renal transplantation. Urinary tract infections (UTI) and cytomegalovirus infections (CMV) are supposed to be their most common clinical form in renal transplant recipients. The influence of UTI on graft function appears to be controversial. Methods: A group of 159 renal transplant recipients was analyzed. Creatinine level during the first 24 months post-transplant was followed. Trends in creatinine level as well as eGFR 24 months post-transplant in groups with and without UTI and CMV were compared. Groups were furthermore differentiated with age, sex and the number of episodes. Linear regression models were used to evaluate the trends in creatinine level, Cocroft-Gault formula was used to estimate GFR. The scores in particular subgroups were analyzed with t-Student test. Results: The increasing creatinine level was observed in group with at least one UTI or CMV episode which was positively correlated to the trend in patients with recurrent UTI's and negatively to the trend in patients without infections. Increasing creatinine level was observed in recipients with at least one UTI episode, younger than median for the analyzed group (< 43) in comparison to older recipients (>44) with at least one UTI episode. Stable creatinine level was observed in women with at least one UTI episode by the opposite to decreasing creatinine level in women without infections. Lower eGFR scores 24 months post-transplant were observed in patients with recurrent infections and women with at least one UTI/CMV episode in comparison to the patients without infections in general as well as to men and women separately. Conclusions: Regarding infectious complications, worse graft function parameters were related to recurrent infections, female sex and younger age of the recipients analyzed in the study.