Effects of ureteral stents on risk of bacteriuria in renal allograft recipients
Abstract
Background
Placement of ureteral stents at the time of renal transplantation is thought to decrease the incidence of postoperative complications, such as anastomotic leakage and stenosis. However, stents may also predispose to post-transplantation urinary tract infection, which can lead to increased risks of graft dysfunction, sepsis, and death. The aim of this study was to analyze the risk of post-transplantation bacteriuria with ureteral stent placement in renal allograft recipients.
Methods
A retrospective single-center analysis was conducted to investigate the incidence of bacteriuria in all renal allograft recipients transplanted between January 2007 and March 2009. Recipients were categorized as in the nonstent group (NSTG) or the stent group (STG). Stent removal was performed per protocol at 6 weeks, and all patients were followed for at least 1 year post transplantation. In the NSTG, the incidence of bacteriuria was assessed at 0–6, 6–12, and 12 weeks to 1 year post transplantation. In the STG, bacteriuria was assessed prior to stent removal, 6 weeks after stent removal, and thereafter until 1 year post transplantation.
Results
A total of 395 renal allograft recipients, 183 in the NSTG and 212 in the STG groups, were studied. The overall incidence of bacteriuria within 1 year post transplantation was similar between NSTG and STG (28.0 vs. 24.0%, P = 0.38). No difference was found in the incidence of bacteriuria when NSTG and STG were compared at 0–6 weeks or prior to stent removal (9.7% vs. 9.1%, P = 0.81), at 6–12 weeks, or 6 weeks after stent removal (6.7% vs. 5.8%, P = 0.75), and thereafter for 1 year post transplantation (13.3% vs. 10.8%, P = 0.46). The incidence of graft failure at 1 year was similar in NSTG and STG (6.2% vs. 4.9%, P = 0.6). Urinary anastomotic leakage occurred in none of the NSTG and 2 of the STG recipients. On multivariate analysis, risk factors for bacteriuria were female recipient gender (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.5–4.3, P = 0.001), delayed graft function (DGF) (OR 2.1, 95% CI 1.2–3.8, P = 0.01), and postoperative Foley catheterization for >5 days (OR 4.7, 95% CI 1.3–17.6, P = 0.02).
Conclusion
Independent risk factors for bacteriuria following kidney transplantation include DGF, prolonged postoperative Foley catheterization, and recipient female gender, but not placement of ureteral stents.
Página original: http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1111%2Ftid.12062
Ureteral stent is basically used in draining fluids or air from pleural spaces internally. At the end of the coil catheter looks like a loop and resembles a pig tail hence this Catheter is called Pigtail Catheter in the medical fraternity. The end of the coil helps to hold the Pigtail Catheter in proper and specific place and used to slow down the flow of fluids injected through the catheter so that they do not apply any pressure or burst out causing injury.
ReplyDeleteUndergoing a kidney stent placement becomes a necessity till the time the renal blockage is healed in a patient. While the stent helps in reliving the obstruction and aiding in urine flow it can also cause painful symptoms in the users. Though the degree of pain experienced by people can vary from a mild one to excruciatingly agonizing episodes based on their individual conditions, there are some basic steps that all of us using a kidney stent can take to help ease the pain and keep it to a minimum.
ReplyDeletefor more details:
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