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This study aims to define the epidemiologic, clinical, and microbiological features of asymptomatic bacteriuria (AB) and cystitis in kidney transplantation recipients (KTRs), and to determine the impact of antimicrobial therapy of AB and the risk factors of cystitis. We conducted a prospective observational study of AB and cystitis in KTRs from January to June 2017. One-hundred ninety seven KTRs were included: 175 (88.8%) with AB and 22 (11.2%) with cystitis. The most frequent etiologies were Escherichia coli, Klebsiellapneumoniae, Enterococcusfaecalis, and Pseudomonas aeruginosa. No differences were observed regarding the etiologies, antimicrobial susceptibility patterns, and microbiologic outcomes in AB vs. cystitis. The treatment of AB diminished the microbiological cure and increased the rates of microbiologic relapses and reinfections, in addition, treated AB patients showed a trend of developing symptomatic urinary tract infection in the following six months. The analysis of the data identified the following independent risk factors for cystitis during the six months of follow-up: AB treatment, thymoglobulin induction, previous acute pyelonephritis, and time since transplantation &lt, 1 year. In summary, considering the lack of clinical benefits of treating AB and its impact on cystitis development in the follow-up, we support the recommendation of not screening for or treating AB.

Background and Aims Kidney transplantation is the treatment of choice in patients with end stage kidney disease (ESKD). In recent years, donation activity and kidney transplant in Spain has suffered a significant increase, accompanied by a change in the profile of donors to cope with the waiting list. It has been produced a decrease in mortality due to traffic accidents, the main source of donation, in contrast, strokes are currently the main source. The donor is of older age and with greater morbidity, especially cardiovascular, which makes doubts about its functionality and Whether this is an adequate strategy to expand the donor pool. The objective To analyze if the survival of the graft is worse in donors of very advanced age with respect to other groups of expanded criteria deceased donors. Method A retrospective analysis was carried out with data from SICATA regarding kidney transplant from a deceased donor with age ≥55 years made between 1/1/06 -12/31/15 at the Virgen del Rocío University Hospital. The graft failure was defined as return to dialysis. 495 cases were obtained, which were divided by the age of the donor in three groups: between 55-65 (N = 310), between 66 -75 (N = 154) and> 75 (N = 31). These groups were compared in terms of graft survival (censored for death) using analysis of survival Kaplan-Meier log-rank. We also performed a multivariate analysis of risk-adjusted graft survival using the Cox proportional hazard technique with the relevant predictive factors and the age of the donor, as a categorical and continuous variable. Analysis with SPSS 24.0. Results The table shows the comparisons between the different population groups and in the Figure is shown the survival functions for each one. Taking into account those results, it cannot be concluded that the age of the donor in these different age groups has significant influence on graft survival with the data we handle. The multivariate analysis concluded that, for this population group and the data handled, the variables that influence the failure of the graft are: the height of the donor, the sex of the recipient and the time in renal replacement therapy. In no case does the age of the donor influence the survival of the graft. Conclusion Kidney transplant improves survival and quality of life in comparison with dialysis long term. Our data did not show significant differences between the different groups of age, which indicates that the use of kidney grafts from elderly donors is acceptable and can greatly expand the donor group. The decision to use or not a kidney elderly donor should be based on the individual characteristics of the donor, as well as in other factors related to the standard clinical criteria for kidney transplant.

Background and Aims Renal transplantation is the best alternative renal replacement option for patients with advanced chronic kidney disease. However, the supply of young donors is limited, and does not cover the demand of patients on the renal transplant waiting list, for this reason are being used older donors and exists a high discard rate of those organs base on pathological results (score) of the preimplant renal biopsy. There are several methods to evaluate the quality of the kidneys and the Kidney Donor Profile Index (KDPI) has acquired special relevance to decide the perform of preimplant renal biopsy. Based on the score, a preimplant renal biopsy is performed, which is decisive in certain cases. However, there is poor evidence to support this decision, which can be described as “conservative,” since there is not enough certainty that there is influence of the preimplant biopsy score score on graft survival. Method 389 biopsies of kidney transplant donors of cadaver donors in brain death and asystole type III were included. Donors in asystole type II, combined and live, were excluded. Samples examined by the same pathologist and in paraffin (no case by freezing). A graft survival analysis was performed based on the results of the renal biopsy (score). Likewise, a multivariate analysis of graft survival was carried out including, in addition to the results of the renal biopsy, results such as the age of the donor and recipient and the KDPI. Results graft survival was compared between two transplant subpopulations in our hospital based on whether a preimplant biopsy was performed. According to the data used there are no significant differences in graft survival between transplants in which biopsy has been performed and those that have not. Conclusion our work shows, as is currently the case in the literature, the absence of influence on the score of the preimplant biopsy score on graft survival.

It is very important to determine as accurately as possible the renal function in potential living renal transplant donors, especially those with limited renal function (CrCl 90 mL/m/1.73 m(2)), age older than 50 years, and cardiovascular risk factors that might favor the development of long-term kidney diseases.The objective of this study was to compare the direct measurement of glomerular filtration rate (GFR) using EDTA-Cr51 and the estimations based on creatinine (eGFR): Cr clearance (CCr) with 24-hour urine and estimated using Cockroft-Gault (adjusted by using body surface area-Mosteller formula-SC), MDRD-4, MDRD-6, and CKD-EPI to determine the usefulness of different methods from EDTA-Cr51to evaluate the kidney function.The kidney function evaluation has been made to 105 potential kidney donors using the EDTA-Cr51 method. The GFR obtained through the EDTA-Cr51 is compared with the CCr values in 24-hour urine and eGFR based on creatinine (Cockcroft-Gault, MDRD4, MDRD6, and CKD-EPI).Using the Bland Altman graphic we have observed that the most dispersed results are obtained with the eGFR using CCr in 24-hour urine and CKD-EPI. By means of PasingBablock, we realized that MDRD-4 and MDRD-6 show the highest approximation to the reference method proposed to be substituted, whereas CCr shows a high dispersion.eGFR using MDRD-4 and MDRD-6 formulas reveal the best adjustment to the measure by EDTA-Cr51. This might represent the best option if a direct eGFR measure is not available.