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Infection is the chief cause of mortality and non‐death censored graft loss in the first year after renal transplantation in a resource limited population: A single centre study
Author(s) -
Gopalakrishnan Vikraman,
Agarwal Sanjay K,
Aggarwal Sandeep,
Mahajan Sandeep,
Bhowmik Dipankar,
Bagchi Soumita
Publication year - 2019
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13401
Subject(s) - medicine , transplantation , population , etiology , pediatrics , environmental health
Aim Few studies have assessed the impact of infections after renal transplantation (RTX) in low and middle income countries. This single centre study aimed to delineate the profile and impact of infections requiring hospitalization (IRH) occurring in the first year after RTX in India. Method Patients who underwent RTX between July 2012 and June 2015 were followed up for 12 months after transplantation. Results 60.2% of the 387 patients studied had at least one IRH and total 492 infections were diagnosed. The most common were urinary tract (30.3%), gastrointestinal (17.1%) and pulmonary (11.2%) infections. Viral aetiology (33.3%) was most frequent, followed by bacterial (23.6%), parasitic (5.1%), tuberculosis (4.5%), and fungal infections (3.9%). 86.4% deaths were due to infections. One year patient and graft survival were inferior among recipients with IRH compared to those with no IRH: 91.8% vs. 98.1% (log rank = 0.010) and 90.1% vs. 97.4% (log rank = 0.006) respectively. Average monthly income per family member <5000 Rupees (75 USD), NODAT, and acute rejection were independent risk factors for IRH. Conclusion The profile of IRH is unique involving opportunistic, community‐acquired and endemic infections seen in this country. It is the predominant cause of mortality and graft loss in the first year after RTX. Poor economic status is an important determinant of IRH in our population.