AUTHOR=Protus Marek , Uchytilova Eva , Indrova Veronika , Lelito Jan , Viklicky Ondrej , Hruba Petra , Kieslichova Eva 

TITLE=Sepsis affects kidney graft function and one-year mortality of the recipients in contrast with systemic inflammatory response

JOURNAL=Frontiers in Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.923524

DOI=10.3389/fmed.2022.923524

ISSN=2296-858X

ABSTRACT=<sec><title>Background</title><p>Infections remain a major cause of morbidity and mortality after kidney transplantation. The aim of our study was to determine the effect of sepsis on kidney graft function and recipient mortality.</p></sec><sec><title>Methods</title><p>A prospective, observational, single-center study was performed. Selected clinical and biochemical parameters were recorded and compared between an experimental group (with sepsis, <italic>n</italic> = 34) and a control group (with systemic inflammatory response syndrome, <italic>n</italic> = 31) comprising kidney allograft recipients.</p></sec><sec><title>Results</title><p>Sepsis worsened both patient (HR = 14.77, <italic>p</italic> = 0.007) and graft survival (HR = 15.07, <italic>p</italic> = 0.007). Overall one-year mortality was associated with age (HR = 1.08, <italic>p</italic> = 0.048), APACHE II score (HR = 1.13, <italic>p</italic> = 0.035), and combination immunosuppression therapy (HR = 0.1, <italic>p</italic> = 0.006), while graft survival was associated with APACHE II (HR = 1.25, <italic>p</italic> = 0.004) and immunosuppression. In sepsis patients, mortality correlated with the maximal dose of noradrenalin (HR = 100.96, <italic>p</italic> = 0.008), fungal infection (HR = 5.64, <italic>p</italic> = 0.024), SAPS II score (HR = 1.06, <italic>p</italic> = 0.033), and mechanical ventilation (HR = 5.97, <italic>p</italic> = 0.033), while graft survival was influenced by renal replacement therapy (HR = 21.16, <italic>p</italic> = 0.005), APACHE II (HR = 1.19, <italic>p</italic> = 0.035), and duration of mechanical ventilation (HR = 1.01, <italic>p</italic> = 0.015).</p></sec><sec><title>Conclusion</title><p>In contrast with systemic inflammatory response syndrome, septic kidney allograft injury is associated with early graft loss and may represent a significant risk of mortality.</p></sec>