{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T02:03:49Z","timestamp":1779329029862,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,9,7]],"date-time":"2016-09-07T00:00:00Z","timestamp":1473206400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The impact of allograft pyelonephritis (<jats:styled-content style=\"fixed-case\">AGPN<\/jats:styled-content>) on renal allograft function is controversial. In this study, we evaluated the incidence, risk factors, and the impact of <jats:styled-content style=\"fixed-case\">AGPN<\/jats:styled-content> on renal allograft function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study in adult renal allograft recipients with 1\u2010year follow\u2010up after transplantation (Tx). Renal allograft function was evaluated by estimated glomerular filtration rate (<jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content>) (by Modification of Diet in Renal Disease formula) and 24\u2010h urine protein excretion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 431 renal allograft recipients were analyzed; 57 (13.2%) developed <jats:styled-content style=\"fixed-case\">AGPN<\/jats:styled-content> within 1 year after Tx. Median time between Tx and <jats:styled-content style=\"fixed-case\">AGPN<\/jats:styled-content> was 50 days. Risk factors for <jats:styled-content style=\"fixed-case\">AGPN<\/jats:styled-content> were the presence of a urological catheter (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>] = 18.93, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] = 8.00\u201344.81, <jats:italic>P<\/jats:italic> &lt; 0.001) and preceding asymptomatic bacteriuria (<jats:styled-content style=\"fixed-case\">ASB<\/jats:styled-content>) (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> = 2.16, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> = 1.20\u20133.90, <jats:italic>P<\/jats:italic> = 0.009). In 72.7%, the causative microorganism of <jats:styled-content style=\"fixed-case\">ASB<\/jats:styled-content> was identical to that of the succeeding <jats:styled-content style=\"fixed-case\">AGPN<\/jats:styled-content> episode. Multivariable linear regression analysis showed that experiencing <jats:styled-content style=\"fixed-case\">AGPN<\/jats:styled-content> did not decrease the <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content> (<jats:italic>P<\/jats:italic> = 0.61) nor did increased proteinuria (<jats:italic>P<\/jats:italic> = 0.29) 1 year after Tx. For the <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content>, an interaction was found between <jats:styled-content style=\"fixed-case\">AGPN<\/jats:styled-content>\/bacteriuria (<jats:styled-content style=\"fixed-case\">BU<\/jats:styled-content>) and acute rejection (<jats:styled-content style=\"fixed-case\">AR<\/jats:styled-content>): the group experiencing <jats:styled-content style=\"fixed-case\">BU<\/jats:styled-content> preceding <jats:styled-content style=\"fixed-case\">AR<\/jats:styled-content> had significantly (<jats:italic>P<\/jats:italic> &lt; 0.001) lower <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content> compared with the group that experienced only <jats:styled-content style=\"fixed-case\">AR<\/jats:styled-content> (21 mL\/min\/1.73 m<jats:sup>2<\/jats:sup> vs. 48 mL\/min\/1.73 m<jats:sup>2<\/jats:sup>), as a result of increased prevalence of combined rejections within the BU group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Indwelling urological catheters and preceding <jats:styled-content style=\"fixed-case\">ASB<\/jats:styled-content> are associated with developing <jats:styled-content style=\"fixed-case\">AGPN<\/jats:styled-content>. An incident of <jats:styled-content style=\"fixed-case\">AGPN<\/jats:styled-content> itself does not impair renal allograft function 1 year after Tx. However, a relevant interaction occurs between <jats:styled-content style=\"fixed-case\">BU<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">AR<\/jats:styled-content>, in which the sequence of occurrence of these 2 events synergistically impairs the <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12568","type":"journal-article","created":{"date-parts":[[2016,7,5]],"date-time":"2016-07-05T15:59:13Z","timestamp":1467734353000},"page":"647-660","source":"Crossref","is-referenced-by-count":18,"title":["Incidence, risk factors, and the impact of allograft pyelonephritis on renal allograft function"],"prefix":"10.1111","volume":"18","author":[{"given":"R.","family":"Singh","sequence":"first","affiliation":[{"name":"Renal Transplant Unit Division of Nephrology Department of Internal Medicine Academic Medical Center\u2013University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.E.","family":"Geerlings","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine Academic Medical Center\u2013University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Peters\u2010Sengers","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine Academic Medical Center\u2013University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.M.","family":"Idu","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery Department of Surgery Academic Medical Center\u2013University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.J.","family":"Hodiamont","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Academic Medical Center\u2013University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.J.M.","family":"ten Berge","sequence":"additional","affiliation":[{"name":"Renal Transplant Unit Division of Nephrology Department of Internal Medicine Academic Medical Center\u2013University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.J.","family":"Bemelman","sequence":"additional","affiliation":[{"name":"Renal Transplant Unit Division of Nephrology Department of Internal Medicine Academic Medical Center\u2013University of Amsterdam Amsterdam The 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