Frailty Status Predicts Urinary Tract Infection Risk Following Kidney Transplant.

IF 2.5 4区医学 Q3 IMMUNOLOGY

Transplant Infectious Disease Pub Date : 2026-07-01 Epub Date: 2026-03-15 DOI:10.1111/tid.70204

Rebecca Unterborn, Liza M Creel, Kristine M Erlandson, Maheen Z Abidi

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引用次数: 0

Abstract

Introduction: Urinary 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.

Methods: We 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.

Results: Among 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.

Conclusion: Frailty 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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虚弱状态预测肾移植后尿路感染风险。

导言：尿路感染（uti）是肾移植（KT）受者最常见的感染性并发症。尿路感染风险与老年人虚弱有关，而尿路感染可能加剧虚弱。然而，这种关系尚未在虚弱和uti风险较高的KT接受者中描述。方法：我们对90名年龄≥50岁的KT受者进行了回顾性图表回顾，这些受者在2021年1月至7月期间接受了KT，移植后随访≥12个月。在每次发生时确定uti。在基线时使用改良的Rockwood-20衰弱指数（mFI）评估衰弱程度；评分≥0.25被认为虚弱，0.08-0.24被认为虚弱，结果：在90名KT接受者中，33名（37%）发生≥1次UTI。值得注意的是，45%患有尿路感染的KT接受者身体虚弱，而没有尿路感染的KT接受者身体虚弱的比例为25%。与非虚弱的KT受者相比，虚弱的KT受者患uti的风险明显更高（HR 8.13, 95% CI 1.89, 34.91; p = 0.005），虚弱前的KT受者也是如此（HR 4.51, 95% CI 1.02, 19.92; p = 0.047）。虚弱的KT受者也经历了更早的UTI发作，21例UTI中有12例（57%）发生在KT后的前30天内。结论：虚弱和脆弱与KT受体尿路感染风险增加有关。这些发现强调了移植后护理中脆弱性评估的重要性，并建议需要有针对性的干预措施来降低这一弱势群体的尿路感染风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant Infectious Disease 医学-传染病学

CiteScore

5.30

自引率

7.70%

发文量

210

审稿时长

4-8 weeks

期刊介绍： Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal. Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.