肾移植术后即刻使用双j型导尿管对尿路感染发生率的影响

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-07-01 DOI:10.1016/j.transproceed.2025.06.007

Sammara Azevedo Guedes , Clara Manuela Silva Sampaio , Gabriel Brayan Gutiérrez-Peredo , Iris Montaño-Castellón , Andrea Jimena Gutiérrez-Peredo , Fernanda Pinheiro Martin Tapioca , Milena Sampaio Barreto Machado , Marcelo Barreto Lopes , Ricardo José Costa Mattoso

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引用次数: 0

摘要

导读：肾移植术后泌尿系统并发症，尤其是尿路感染（uti），严重影响移植肾的生存和生活质量。双j型导管用于预防并发症，但其对尿路感染发展的影响尚不清楚。本研究评估移植后前3个月双j型导管（PDJC）的使用情况，检查相关并发症和导管时间的影响。方法：这项回顾性、准实验研究分析了2021年至2023年年龄≥18岁的肾移植受者，患者分配取决于相对于机构方案实施的移植时间。非PDJC患者于2021年至2022年接受移植，而PDJC患者在更新机构协议后于2023年接受移植。Logistic回归分析确定了尿路感染的危险因素，其相关性以比值比（OR）表示，95%置信区间（CI）。对未调整和调整的模型进行逻辑回归，以评估不使用PDCJ和UTI作为混杂变量之间的关系。结果：在202例肾移植患者中（平均年龄45.5±13岁，58%为男性，93%为非白人），总体尿路感染发生率为38%，PDJC组明显低于对照组（31% vs 45%, P = 0.046）。短期置管（≤10天）的UTI发生率最低，为25%，而延长置管时间（≥30天）与感染频率增加相关。多变量分析发现女性性别是尿路感染发生的独立危险因素(OR = 2.29；95% ci: 1.28；4.09, p = 0.005)。缺少PDJC几乎使UTI风险增加一倍(OR = 1.80；95% ci: 1.0；3.18)在控制了潜在混杂因素后。结论：PDJC使用≤10天与移植后即刻尿路感染风险降低相关，而女性是一个独立的危险因素。这些发现表明，较短的导管时间可能有助于优化肾移植后感染预防策略。

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

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.

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.