Impact of Protocolized Double-J Catheter Use on the Incidence of Urinary Tract Infection in the Immediate Postkidney Transplant Period.

Abstract

Introduction: Urological complications after renal transplantation, particularly urinary tract infections (UTIs), significantly affect graft survival and quality of life. Double-J catheters are used to prevent complications, but their impact on UTI development remains unclear. This study evaluates protocolized double-J catheter (PDJC) use in the first 3 months post-transplant, examining associated complications and the influence of catheter duration.

Methods: This retrospective, quasi-experimental study analyzed kidney transplant recipients aged ≥18 years from 2021 to 2023, with patient assignment determined by timing of transplantation relative to institutional protocol implementation. Non-PDJC patients were transplanted in 2021 to 2022, while PDJC patients received transplants in 2023 following updated institutional protocols. Logistic regression analysis identified UTI risk factors, with associations expressed as odds ratios (OR) with 95% confidence intervals (CI). A logistic regression was performed with both unadjusted and adjusted models to assess the association between the absence of PDCJ use and UTI as confounding variables.

Results: Among 202 renal transplant patients analyzed (mean age 45.5 ± 13 years, 58% male, 93% non-white), overall UTI incidence was 38%, with significantly lower rates in the PDJC group compared to controls (31% vs 45%, P = .046). Short-term catheter placement (≤10 days) achieved the lowest UTI rate at 25%, whereas prolonged catheter duration (≥30 days) was associated with increased infection frequency. Multivariable analysis identified female sex as an independent risk factor for UTI development (OR = 2.29; 95% CI: 1.28; 4.09, P = .005). The absence of PDJC nearly doubled UTI risk (OR = 1.80; 95% CI: 1.0; 3.18) after controlling for potential confounders.

Conclusion: PDJC use for ≤10 days was associated with reduced UTI risk in the immediate post-transplant period, while female sex emerged as an independent risk factor. These findings suggest that shorter catheter duration protocols may help optimize infection prevention strategies following kidney transplantation.