UTI in kidney transplant

World J Urol. 2020 Jan;38(1):81-88. doi: 10.1007/s00345-019-02742-6. Epub 2019 Apr 1.

Abstract

Urinary tract infection (UTI) remains the most common type of infection contracted by kidney transplant patients. UTI reduces both patient and graft survival. Understanding and managing UTI in transplant patients requires an appreciation of their unique anatomy and physiology. Both the transplant and native urinary systems can be affected by upper and/or lower urinary tract infections. Factors that contribute to UTI in kidney transplant patients are numerous and interact with each other. Factors can include excessive immunosuppression by medications and/or chronic disease, foreign material in the urinary system, transplant kidneys affected by ischaemia-reperfusion injury, non-functioning native kidneys, and abnormal lower urinary tracts. Research is ongoing to highlight the roles each of these contributing factors play and how they may be mitigated to reduce the incidence of UTI. Antimicrobials remain the mainstays of treatment and prophylaxis and this has promoted the development of multi-drug resistant organisms. This challenge necessitates awareness of UTI and methods to reduce rates by all healthcare professionals involved in kidney transplantation.

Keywords: ABU; Infection; Kidney; Transplant; UTI; Urology.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Global Health
  • Graft Rejection / epidemiology*
  • Graft Rejection / prevention & control
  • Graft Survival
  • Humans
  • Immunosuppression Therapy / methods*
  • Incidence
  • Kidney Transplantation / adverse effects*
  • Urinary Tract Infections / epidemiology*
  • Urinary Tract Infections / prevention & control

Substances

  • Anti-Bacterial Agents