ADVERTISEMENT

ADVERTISEMENT

INFECCIONES URINARIAS EN SITUACIONES ESPECIALES: TRASPLANTE RENAL Y DIÁLISIS

María José Pomares

Resumen


Los pacientes en hemodiálisis frecuentemente tienen más infecciones del tracto urinario (ITUs) debido al estado de inmunodepresión, la falta de remoción de gérmenes, la presencia de litiasis, vejiga neurogénica, anomalías en vía urinaria, uso de catéteres endovenosos y sondas vesicales. Los antibióticos empleados en el tratamiento de las ITUs en la población general pueden emplearse en pacientes en hemodiálisis con el correspondiente ajuste de la dosis. La ITU es la infección bacteriana más común en los receptores de trasplante renal debido a factores como el tratamiento inmunosupresor, ITUs previas al trasplante, reflujo vesicoureteral, poliquistosis renal, diabetes, uso prolongado de catéteres urológicos, retraso en la función del injerto, episodios de rechazo agudo, bacteriuria asintomática a repetición y falta de profilaxis antibiótica. Se presentan principalmente en el postoperatorio inmediato y los primeros meses postrasplante. La repetición de las ITUs o episodios de BA pueden desencadenar rechazo agudo.


Palabras clave


insuficiencia renal crónica; piuria; hemodiálisis; nefropatía; trasplante renal; vejiga neurogénica

Texto completo:

PDF

Referencias


Marinovich S, Lavorato C, Bisigniano L, et al. Registro argentino de diálisis crónica 2014-2015. Sociedad Argentina de Nefrología e Instituto Nacional Central Único Coordinador de Ablación e Implante. Buenos Aires 2016.

Nitzan O, Elias M , Chazan B, et al. Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence ,diagnosis and management. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2015;8: 129-36.

Yu S, Fu A, Qiu Y, et al. Disease burden of urinary tract infections among type 2 diabetes mellitus patients in the US. J Diabetes Complication 2014; 28(5): 621-6.

Hsiao C, Lin H, Lin Y, et al. Urinary tract infection in patients with chronic kidney disease.Turk Journal of Medical Sciences 2014; 44(1): 145-9.

Nugent R, Fathima S, Feigl A, et al. The burden of chronic kidney disease on developing nations: a 21st century challenge in global health. Nephron Clin Pract. 2011; 118(3): 269-77.

Levey A, Atkins R, Coresh J, et al. Chronic kidney disease as global public health problem: approaches and initiatives. A position statement from Kidney Disease Improving Global Outcomes. Kidney Int 2007; 72: 247-59.

Patterson J, Andriole V. Bacterial urinary tract infections in diabetes. Infect Dis Clin North Am 1997; 11(3): 735-50.

Shah B, Hux J. Quantifyting the risk of infectious diseases for people with diabetes. Diabetes Care 2003; 26(2): 510-13.

Gilbert DN. Urinary Tract infections in patients with chronic renal insufficiency. Clin J Am Soc Nephrol 2006; 1(2): 327-31.

Tandogdu Z, Cai T, Koves B, et al. Urinary tract infections in inmunocompromised patients with diabetes, chronic kidney disease and kidney transplant. Eur Urol Focus 2016; 2(4): 394-99.

Falah S, Ammer A, Kais H. Urinary tract infection in hemodialysis patients with renal failure. J Fac Med Baghdad. 2012; 54(1): 38-41.

Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Am J Med. 2002; 113 (Suppl 1A): S14-S19.

Hooton T. The current management strategies for community acquired urinary tract infection. Infect Dis Clin North Am 2003, 17(2): 303-32.

Vij R, Natarajav S, Peixoto A. Diagnostic utility of urinalysis in detecting urinary tract infection in hemodialysis patients. Nephron Clin Pract 2009; 113(4): 281-5.

Fasolo LR, Rocha LM, Campbell S, et al. Diagnostic relevance of pyuria in dialysis patients. Kidney International 2006; 70(11): 2035-38.

Oikonomou KG, Alhaddad A. The diagnostic value of urinalysis in hemodialysis patients with fever, sepsis or suspected urinary tract infection. Journal of Clinical and Diagnostic Research 2016; 10(10): 11-13.

Mortazavi M, Seyraian S, Shahidi S, et al. Pyuria as a screening test for detection of urinary tract infection in patients on long term hemodialysis. Iranian Journal of Kidney Disease 2011;5: 50-52.

Papasotiriou M, Savvidaki E, Kalliakmani P, et al. Predsiposing factors to the development of urinary tract infections in renal transplat recipients and the impact on the long term graft function. Renal Failure 2011; 33(4): 405-10.

Veroux M, Giuffrida G, Corona D, et al. Infective complications in renal allograft recipients: epidemiology and outcome. Transplant Proc 2008; 40(6): 1873-76.

Britt NS, Hagopian JC, Brennan DC, et al. Effects of recurrent urinary tract infections on graft and patient outcomes after kidney transplantation. Nephrol Dial Transplant 2017; 32(10) 1758-66.

Vidal E, Cervera C, Cordero E, et al. Executive summary. Management of urinary tract infection in solid organ transplant recipients: consensus statementof the group for the study of infection in transplant recipients (GESITRA) of the Spanish Society of infectious disease and clinical microbiology (SEIMC) and the Spanish Network for research in infectious disease (REIPI). Enfern Infecc Microbiol Clin 2015; 33(10): 680-7.

Singh R, Geerlings SE, Bemelman FJ. Asymptomatic bacteriuria and urinary tract infections among renal allograft recipients. Curr Opin Infect Dis 2015; 28(1): 112-6.

Schmaldienst S, Dittrich E, Horl W, et al. Urinary tract infections after renal transplantation. Curr Opin Infect Dis 2002; 12(2): 125-30.

Di Cocco P, Orlano G, Mazzotta C, et al. Incidence of urinary tract infections caused by germs resistant to antibiotics commonly used after renal transplantation. Transplant Pro 2008; 40(6) 1881-4.

Renoult E, Aouragh F, Mayeux D, et al. Urinary tract infections during the 1st month after kidney transplantation. Agressologie 1992;33(3): 147-50.




Copyright (c) 2019 Sociedad Argentina de Diabetes Asociación Civil

ADVERTISEMENT

ADVERTISEMENT