ABSTRACT
INTRODUCTION: Kidney transplantation is now a routine method used to treat end-stage renal disease. About 10 % of kidney transplant patients are patients with autosomal dominant polycystic kidney disease (ADPKD). After successful kidney transplantation, recurrent urinary tract infections also occur in initially asymptomatic patients. MATERIAL AND METHODS: The group included 320 patients after kidney transplantation. We compared patients with ADPKD versus patients without ADPKD in terms of the presence of recurrent urinary tract infections. THE RESULTS: The incidence of recurrent urinary tract infections (rIMCs) was 18% in patients without ADPKD and 48% in patients without ADPKD. Nephrectomy after kidney transplantation due to recurrent urinary tract infections eliminated this infectious complication (in 86% of patients). CONCLUSION: Kidney transplant patients with ADPKD have a significantly higher incidence of recurrent urinary tract infections. Removal of polycystic kidneys is a suitable solution if the infection persists.
Subject(s)
Kidney Transplantation , Polycystic Kidney Diseases , Polycystic Kidney, Autosomal Dominant , Urinary Tract Infections , Humans , Kidney Transplantation/adverse effects , Nephrectomy/methods , Polycystic Kidney Diseases/complications , Polycystic Kidney Diseases/surgery , Polycystic Kidney, Autosomal Dominant/complications , Polycystic Kidney, Autosomal Dominant/surgery , Retrospective Studies , Urinary Tract Infections/complications , Urinary Tract Infections/epidemiologyABSTRACT
OBJECTIVES: The aim of our analysis was to evaluate the impact of the COVID-19 pandemic on the procurement program and kidney transplantation in Slovakia and to identify the risk factors for a severe course of COVID-19 disease, as well as the risk factors for COVID-19 fatalities, with the focus on the parameters preceding the infection. We compared morbidity and mortality from COVID-19 before and after the spread of the alpha variant of the virus and the same among transplant (KTRs) and haemodialysis patients in Slovakia. METHODS: 305 KTRs (68.8 % males) with confirmed SARS-CoV-2 positivity were included in the multicentric retrospective analysis. The patients were split into subgroups based on the time of falling ill and their clinical course. RESULTS: The procurement program and kidney transplants in Slovakia dropped in the observed period by 28.6 % (p<0.0001) and by 33.5 % (p<0.0001) respectively. Age over 59 years (p=0.0088) and diabetes mellitus (p=0.0106) were identified as independent risk factors for severe course of the disease. Risk factors for death were the age over 59 years (p=0.0003) and graft dysfunction with CKD-EPI<0.5 mL/s (p=0.0029). The prevalence of the alpha variant in Slovakia was associated with a severe course in KTRs treated with corticoids (p=0.0273) and in graft dysfunction with CKD-EPI<0.5 mL/s (p=0.0076); the risk of death was higher in KTRs over 59 years (p=0.0173) and again with CKD-EPI<0.5 mL/s (p=0.0393). KTRs had a 3.7 times lower risk of infection compared to the haemodialysis patients (p<0.0001), with mortality of 9.8 % vs 30â % (p<0.0001). CONCLUSION: The procurement and transplant program is sustainable even during a pandemic, provided that measures are set up quickly. Morbidity and mortality from COVID-19 in KTRs was comparable to the situation in EU countries. Patients in the haemodialysis program had a worse prognosis (Tab. 5, Fig. 1, Ref. 21) Keywords: COVID-19, kidney transplantation, dialysis, immunosuppression, obesity, diabetes mellitus.
