Does early removal of double J stents reduce urinary infection in living donor renal transplantation?

Soylu, Lütfi; Aydın, Oğuz; Atli, Muzaffet; Gunt, Ceren; Ekmekci, Yakup; Çekmen, Nedim; Karademir, Sedat

doi:10.5114/aoms.2018.73524

Cited by 6 publications

(3 citation statements)

References 25 publications

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“…Placement of the D-J tube during kidney transplantation could be used to protect against vesicoureteral anastomosis, which may be a potential risk factor for early urinary tract infection after kidney transplantation. 26 In previous studies, shortening the placement time of D-J tube led to reduced incidence of urinary tract infection and did not increase the occurrence of urinary leakage or ureteral obstruction. 27 Urinary catheter is another reported risk factor for urinary tract infection, and the risk of urinary tract infection increases by 3% to 7% for patients with urinary catheter indwelling for more than 1 day after kidney transplantation.…”

Section: Discussionmentioning

confidence: 86%

Retrospective Analysis of the Risk Factors of Perioperative Bacterial Infection and Correlation with Clinical Prognosis in Kidney Transplant Recipients

Cheng¹,

Li²,

Wang³

et al. 2022

IDR

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Section: Discussionmentioning

confidence: 86%

Retrospective Analysis of the Risk Factors of Perioperative Bacterial Infection and Correlation with Clinical Prognosis in Kidney Transplant Recipients

Cheng¹,

Li²,

Wang³

et al. 2022

IDR

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“…This observation suggests that utilizing the concept of “stent-related UTIs” instead of “UTIs in the first 3- or 6-months posttransplantation” maybe more logical and is likely to be a better indicator about the impact of the timing of urinary stent removal on the UTIs. Otherwise, the impact of stent on UTIs can get “diluted with time” and studies may become underpowered to detect significance difference between the two arms [ 5 , 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Timing of Stent Removal on the Incidence of UTI, Recurrence, Symptomatology, Resistance, and Hospitalization in Renal Transplant Recipients

Arabi

Thiab

Altheaby

et al. 2021

Journal of Transplantation

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Purpose. To evaluate the impact of early (<3 weeks) versus late (>3 weeks) urinary stent removal on urinary tract infections (UTIs) post renal transplantation. Methods. A retrospective study was performed including all adult renal transplants who were transplanted between January 2017 and May 2020 with a minimum of 6-month follow-up at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Results. A total of 279 kidney recipients included in the study were stratified into 114 in the early stent removal group (ESR) and 165 in the late stent removal group (LSR). Mean age was 43.4 ± 15.8; women: n: 114, 40.90%; and deceased donor transplant: n: 55, 19.70%. Mean stent removal time was 35.3 ± 28.0 days posttransplant (14.1 ± 4.6 days in the ESR versus 49.9 ± 28.1 days in LSR, p < 0.001 ). Seventy-four UTIs were diagnosed while the stents were in vivo or up to two weeks after the stent removal “UTIs related to the stent” (n = 20, 17.5% in ESR versus n = 54, 32.7% in LSR; p = 0.006 ). By six months after transplantation, there were 97 UTIs (n = 36, 31.6% UTIs in ESR versus n = 61, 37% in LSR; p = 0.373 ). Compared with UTIs diagnosed after stent removal, UTIs diagnosed while the stent was still in vivo tended to be complicated (17.9% versus 4.9%, p : 0.019), recurrent (66.1% versus 46.3%; p : 0.063), associated with bacteremia (10.7% versus 0%; p : 0.019), and requiring hospitalization (61% versus 24%, p : 0.024). Early stent removal decreased the need for expedited stent removal due to UTI reasons (rate of UTIs before stent removal) (n = 11, 9% in the early group versus n = 45, 27% in the late group; p = 0.001 ). The effect on the rate of multidrug-resistant organisms (MDRO) was less clear (33% versus 47%, p : 0.205). Early stent removal was associated with a statistically significant reduction in the incidence of UTIs related to the stent (HR = 0.505, 95% CI: 0.302-0.844, p = 0.009 ) without increasing the incidence of urological complications. Removing the stent before 21 days posttransplantation decreased UTIs related to stent (aOR: 0.403, CI: 0.218-0.744). Removing the stent before 14 days may even further decrease the risk of UTIs (aOR: 0.311, CI: 0.035- 2.726). Conclusion. Early ureteric stent removal defined as less than 21 days post renal transplantation reduced the incidence of UTIs related to stent without increasing the incidence of urological complications. UTIs occurring while the ureteric stent still in vivo were notably associated with bacteremia and hospitalization. A randomized trial will be required to further determine the best timing for stent removal.

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“…There was an independent and positive association between LMR max and the 28-day and 1-year survival rates. Sepsis, a leading cause of mortality worldwide, is defined as a syndrome of physiological, pathological, and biochemical abnormalities induced by infection [19][20][21][22]. The incidence of sepsis is increasing [23,24].…”

Section: -Confidence Interval G -Group Lmr -Lymphocyte-to-monocymentioning

confidence: 99%

Effect of lymphocyte-to-monocyte ratio on survival in septic patients: an observational cohort study

Qin

et al. 2020

Arch Med Sci

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Introduction: The purpose of the present study was to evaluate the potential relationship of lymphocyte-to-monocyte ratio (LMR) with outcomes of septic patients at intensive care unit (ICU) admission. Material and methods: 3087 septic patients were included in the final cohort by using the Medical Information Mart for Intensive Care (MIMIC) database. We evaluated the association of different groups of LMR max with 28-day survival and 1-year survival via Kaplan-Meier (K-M) analysis and Cox regression analysis. Subgroups analysis of LMR max was performed to further explore the effect of LMR max on survival. Results: According to the optimal cutoff value, the cohort was divided into low-LMR max and high-LMR max groups. The 28-day and 1-year survival rates were 47.9% and 19.9%, respectively, in the low-LMR max group, and 60.4% and 25.9%, respectively, in the high-LMR max group. Univariate logistic regression and K-M analyses revealed that the 28-day and 1-year survival rates of the high-LMR max group were higher than those of the low-LMR max group (both p < 0.001). A subgroup analysis of LMR max identified a significant stepwise decrease in the risk of death at 28 days and 1 year from group 1 to group 4 (LMR max increased gradually) after adjustment for multiple variables. Conclusions: We report for the first time that a lower LMR max value is independently predictive of a poor prognosis in septic patients. Therefore, as an inexpensive and readily available indicator, LMR max may facilitate stratification of prognosis in septic patients.

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Does early removal of double J stents reduce urinary infection in living donor renal transplantation?

Cited by 6 publications

References 25 publications

Retrospective Analysis of the Risk Factors of Perioperative Bacterial Infection and Correlation with Clinical Prognosis in Kidney Transplant Recipients

Retrospective Analysis of the Risk Factors of Perioperative Bacterial Infection and Correlation with Clinical Prognosis in Kidney Transplant Recipients

The Impact of Timing of Stent Removal on the Incidence of UTI, Recurrence, Symptomatology, Resistance, and Hospitalization in Renal Transplant Recipients

Effect of lymphocyte-to-monocyte ratio on survival in septic patients: an observational cohort study

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