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. 2009 Jun;24(6):1129-36.
doi: 10.1007/s00467-007-0690-0. Epub 2008 Jan 16.

Urinary tract infections in children after renal transplantation

Ulrike John  1 , Markus J Kemper
Affiliations

Urinary tract infections in children after renal transplantation

Ulrike John et al. Pediatr Nephrol. 2009 Jun.

Abstract

Urinary tract infections (UTI) after pediatric kidney transplantation (KTX) are an important clinical problem and occur in 15-33% of patients. Febrile UTI, whether occurring in the transplanted kidney or the native kidney, should be differentiated from afebrile UTI. The latter may cause significant morbidity and is usually associated with acute graft dysfunction. Risk factors for (febrile) UTI include anatomical, functional, and demographic factors as well as baseline immunosuppression and foreign material, such as catheters and stents. Meticulous surveillance, diagnosis, and treatment of UTI is important to minimize acute morbidity and compromise of long-term graft function. In febrile UTI, parenteral antibiotics are usually indicated, although controlled data are not available. As most data concerning UTI have been accumulated retrospectively, future prospective studies have to be performed to clarify pathogenetic mechanisms and risk factors, improve prophylaxis and treatment, and ultimately optimize long-term renal graft survival.

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Figures

Fig. 1
Fig. 1
Longitudinal power Doppler ultrasonogram of a patient with transplant pyelonephritis showing vascular hypoperfusion in the cortex
Fig. 2
Fig. 2
99mTc DMSA scan of a patient with acute transplant pyelonephritis showing an uptake defect in the lower pole (arrow)
See this image and copyright information in PMC

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