Background Urinary Tract Infections (UTIs) are the second most common cause of graft dysfunction, accounting for significant morbidity, and are associated with poor graft and patient survival. This study aimed to determine the association between post-renal transplant UTI and graft outcomes.

Methods We examined the effect of UTIs on graft outcomes in patients who underwent renal transplantation surgery between January 2010 and December 2022. The study population included 349 renal transplantations, of which 74 experienced 140 UTI events. Based on the number of UTI episodes, patients were categorized into three groups

Results Of the 349 recipients, 275 (74.4%) had no UTI, 47 (18.8%) had nonrecurrent UTIs (NR-UTIs), and 27 (6.8%) had Recurrent UTIs (R-UTIs). NR-UTIs were associated with very poor graft survival compared with no UTI (Hazard Ratio [HR], 2.312; 95% Confidence Interval [CI], 1.410–3.791; P=0.001). This relationship persisted even after adjusting for confounding factors in Multivariable Cox regression analysis (HR, 2.318; 95% CI, 1.414–3.800; P=0.001). Although R-UTIs appeared to result in poor patient survival, the difference was not significant (vs No UTI, HR, 1.517; 95% CI, 0.983–2.342; P=0.060). There appeared to be higher patient survival in R-UTIs but was not significant (vs NR-UTI, HR, 1.316; 95% CI, 0.486–3.564; P=0.589). R-UTIs were more likely to be associated with Multi-drug Resistant Gram-negative organisms (Klebsiella pneumonia or Escherichia coli) with resistance to Nitrofurantoin (RR, 2.753; 95% CI, 1.257–6.032; P=0.01) and Carbapenem (RR, 2.064; 95% CI, 0.988–4.314; P=0.05).

Conclusion NR-UTIs were associated with poorer graft and patient outcomes than no UTI.

The authors have declared no competing interest.

This study did not receive any funding

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics Committee of Ramaiah Medical College, its Institutional Review Board had received the study protocol and meeting was conducted and gave ethical approval for the study on 22-02-2023 (DRP/IFP1085/2023). As the study is retrospective, waiver for consent was provided by IRB

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Yes

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All data produced in the present study are available upon reasonable request to the authors