Urinary infections in special situations: kidney transplant and dialysis

Authors

  • María José Pomares Penna Hospital, Clinics of the Center for Kidney Diseases and Arterial Hypertension, Autonomous City of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v53i1.145

Keywords:

chronic renal insufficiency, pyuria, hemodialysis, nephropathy, kidney transplant, neurogenic bladder

Abstract

Patients on hemodialysis often have more urinary tract infections (UTIs) due to immunosuppression, lack of germ removal, presence of lithiasis, neurogenic bladder, abnormalities in the urinary tract, use of intravenous catheters and urinary catheters. The antibiotics used in the treatment of UTIs in the general population can be used in hemodialysis patients with the corresponding adjustment of dose. UTI is the most common bacterial infection in kidney transplant recipients due to factors such as immunosuppressive therapy, UTIs prior to transplantation, vesicoureteral reflux, polycystic kidney disease, diabetes, prolonged use of urinary catheters, delay in graft function, episodes of acute rejection, recurrent asymptomatic bacteriuria and lack of antibiotic prophylaxis. They occur mainly in the immediate post-surgery period and the first months after transplant. The recurrence of UTIs or AB episodes can trigger acute rejection.

Author Biography

María José Pomares, Penna Hospital, Clinics of the Center for Kidney Diseases and Arterial Hypertension, Autonomous City of Buenos Aires, Argentina

Medical Specialist in Nephrology and specialized in diabetes, Penna Hospital, Clinics of the Center for Kidney Diseases and Arterial Hypertension

References

Marinovich S, Lavorato C, Bisigniano L, et al. Registro argentino de diálisis crónica 2014-2015. Sociedad Argentina de Nefrología e Instituto Nacional Central Único Coordinador de Ablación e Implante. Buenos Aires 2016.

Nitzan O, Elias M , Chazan B, et al. Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence ,diagnosis and management. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2015;8: 129-36.

Yu S, Fu A, Qiu Y, et al. Disease burden of urinary tract infections among type 2 diabetes mellitus patients in the US. J Diabetes Complication 2014; 28(5): 621-6.

Hsiao C, Lin H, Lin Y, et al. Urinary tract infection in patients with chronic kidney disease.Turk Journal of Medical Sciences 2014; 44(1): 145-9.

Nugent R, Fathima S, Feigl A, et al. The burden of chronic kidney disease on developing nations: a 21st century challenge in global health. Nephron Clin Pract. 2011; 118(3): 269-77.

Levey A, Atkins R, Coresh J, et al. Chronic kidney disease as global public health problem: approaches and initiatives. A position statement from Kidney Disease Improving Global Outcomes. Kidney Int 2007; 72: 247-59.

Patterson J, Andriole V. Bacterial urinary tract infections in diabetes. Infect Dis Clin North Am 1997; 11(3): 735-50.

Shah B, Hux J. Quantifyting the risk of infectious diseases for people with diabetes. Diabetes Care 2003; 26(2): 510-13.

Gilbert DN. Urinary Tract infections in patients with chronic renal insufficiency. Clin J Am Soc Nephrol 2006; 1(2): 327-31.

Tandogdu Z, Cai T, Koves B, et al. Urinary tract infections in inmunocompromised patients with diabetes, chronic kidney disease and kidney transplant. Eur Urol Focus 2016; 2(4): 394-99.

Falah S, Ammer A, Kais H. Urinary tract infection in hemodialysis patients with renal failure. J Fac Med Baghdad. 2012; 54(1): 38-41.

Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Am J Med. 2002; 113 (Suppl 1A): S14-S19.

Hooton T. The current management strategies for community acquired urinary tract infection. Infect Dis Clin North Am 2003, 17(2): 303-32.

Vij R, Natarajav S, Peixoto A. Diagnostic utility of urinalysis in detecting urinary tract infection in hemodialysis patients. Nephron Clin Pract 2009; 113(4): 281-5.

Fasolo LR, Rocha LM, Campbell S, et al. Diagnostic relevance of pyuria in dialysis patients. Kidney International 2006; 70(11): 2035-38.

Oikonomou KG, Alhaddad A. The diagnostic value of urinalysis in hemodialysis patients with fever, sepsis or suspected urinary tract infection. Journal of Clinical and Diagnostic Research 2016; 10(10): 11-13.

Mortazavi M, Seyraian S, Shahidi S, et al. Pyuria as a screening test for detection of urinary tract infection in patients on long term hemodialysis. Iranian Journal of Kidney Disease 2011;5: 50-52.

Papasotiriou M, Savvidaki E, Kalliakmani P, et al. Predsiposing factors to the development of urinary tract infections in renal transplat recipients and the impact on the long term graft function. Renal Failure 2011; 33(4): 405-10.

Veroux M, Giuffrida G, Corona D, et al. Infective complications in renal allograft recipients: epidemiology and outcome. Transplant Proc 2008; 40(6): 1873-76.

Britt NS, Hagopian JC, Brennan DC, et al. Effects of recurrent urinary tract infections on graft and patient outcomes after kidney transplantation. Nephrol Dial Transplant 2017; 32(10) 1758-66.

Vidal E, Cervera C, Cordero E, et al. Executive summary. Management of urinary tract infection in solid organ transplant recipients: consensus statementof the group for the study of infection in transplant recipients (GESITRA) of the Spanish Society of infectious disease and clinical microbiology (SEIMC) and the Spanish Network for research in infectious disease (REIPI). Enfern Infecc Microbiol Clin 2015; 33(10): 680-7.

Singh R, Geerlings SE, Bemelman FJ. Asymptomatic bacteriuria and urinary tract infections among renal allograft recipients. Curr Opin Infect Dis 2015; 28(1): 112-6.

Schmaldienst S, Dittrich E, Horl W, et al. Urinary tract infections after renal transplantation. Curr Opin Infect Dis 2002; 12(2): 125-30.

Di Cocco P, Orlano G, Mazzotta C, et al. Incidence of urinary tract infections caused by germs resistant to antibiotics commonly used after renal transplantation. Transplant Pro 2008; 40(6) 1881-4.

Renoult E, Aouragh F, Mayeux D, et al. Urinary tract infections during the 1st month after kidney transplantation. Agressologie 1992;33(3): 147-50.

Published

2023-01-10

How to Cite

Pomares, M. J. (2023). Urinary infections in special situations: kidney transplant and dialysis. Journal of the Argentine Society of Diabetes, 53(1), 48–50. https://doi.org/10.47196/diab.v53i1.145

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