ArticleTransplant infectious disease : an official journal of the Transplantation Society
Frailty Status Predicts Urinary Tract Infection Risk Following Kidney Transplant.
Article in Transplant infectious disease : an official journal of the Transplantation Society. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionUrinary tract infections (UTIs) are the most common infectious complication in kidney transplant (KT) recipients. UTI risk is associated with frailty in older adults, and UTIs may exacerbate frailty. However, this relationship has not been described in KT recipients who are at both greater risk of frailty and UTIs.
methodsWe conducted a retrospective chart review of 90 KT recipients aged ≥ 50 years who underwent KT between January and July 2021 and had ≥ 12 months of post-transplant follow-up. UTIs were identified at the time of each occurrence. Frailty was assessed at baseline using the modified Rockwood-20 frailty index (mFI); scores ≥ 0.25 were considered frail, 0.08-0.24 pre-frail, and < 0.08 non-frail. The primary outcome was cumulative UTI occurrence based on frailty status, analyzed using Cox proportional hazards regression.
resultsAmong 90 KT recipients, 33 (37%) developed ≥ 1 UTI. Notably, 45% of KT recipients with UTIs were frail, compared to 25% of KT recipients without UTIs. Compared to non-frail KT recipients, frail KT recipients had a significantly higher risk of UTIs (HR 8.13, 95% CI 1.89, 34.91; p = 0.005), as did pre-frail KT recipients (HR 4.51, 95% CI 1.02, 19.92; p = 0.047). Frail KT recipients also experienced earlier UTI onset, with 12 out of 21 total UTIs (57%) occurring within the first 30 days post-KT.
conclusionFrailty and prefrailty are associated with increased UTI risk in KT recipients. These findings highlight the importance of frailty assessment in post-transplant care and suggest the need for targeted interventions to reduce UTI risk in this vulnerable population.
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