Acute Graft Pyelonephritis Does Not Adversely Affect Long-Term Transplant Outcomes

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Acute graft pyelonephritis (AGPN) in renal transplant recipients does not impair long-term graft function, according to Spanish researchers.

Researchers led by José María Aguado, MD, of University Hospital 12 de Octubre in Madrid, reviewed data from 189 patients undergoing renal transplantation. The group had a mean age 49.7 years and included 113 men and 76 women. Of these, 19 (10%) were diagnosed with 25 episodes of AGPN, for an incidence rate of 4.4 episodes per 100 patient-years.

During a 36-month follow-up period, serum creatinine levels, creatinine clearance, and 24-hour proteinuria did not differ significantly between patients with and without AGPN, the authors reported online in Nephrology Dialysis Transplantation. AGPN did not have any effect on the risk of decline in renal graft function, which the researchers defined as a greater than 0.33 mg/dL increase in serum creatinine level between three and 12 months after transplantation.

The presence of glomerulonephritis as the underlying disease was independently associated with a 4.2 times increased odds of AGPN. The previous occurrence of two to five or more than five episodes of asymptomatic bacteriuria after transplantation were independently associated with a 9.4 times and 19.8 times increased odds, respectively.

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