Influence of intravenous iron on bacterial infection risk immediately following kidney transplantation.

Kidney transplant recipients are at higher risk of infections due to immunosuppression, especially in the perioperative period after receiving induction therapy. Administration of iron has been linked to bacterial infections. This study investigated if receipt of intravenous iron at the time of kidney transplant increased bacterial infections post-transplant. This single-center, retrospective study compared patients who received intravenous iron at the time of kidney transplant to those who did not. Patients were followed for 12 weeks after transplant. The primary outcome was incidence of bacterial infections following transplant; hemoglobin and transfusion needs were also examined. A total of 416 patients who received intravenous iron were compared to 416 patients who did not. Bacterial infections were similar between groups (14.4% iron group vs. 15.9% non-iron group). Intravenous iron did not influence bacterial infections on univariable or multivariable analyses when other infection confounders were accounted for. Patients who did not receive intravenous iron required more packed red blood cell transfusions in the 3 months following transplantation, but this was driven by factors other than intravenous iron as demonstrated by a post-hoc analysis. Intravenous iron did not increase the risk of bacterial infections in the immediate post-kidney transplant setting. Bacterial infections after transplant were associated with female sex, increasing age at transplant, receipt of transfusions, and increased duration of urinary catheters.

January SE ，Dubrawka CA ，Progar K ，Kurwicki K ，Delos Santos R ... -  《-》

Infections Following Kidney Transplantation After Exposure to Immunosuppression for Treatment of Glomerulonephritis.

Massicotte-Azarniouch D ，Detwiler RK ，Hu Y ，Falk RJ ，Saha MK ，van Duin D ，Hogan SL ，Derebail VK ... -  《-》

Vitamin D deficiency is associated with increased risk of bacterial infections after kidney transplantation.

Park YJ ，Kim SU ，Lee KH ，Lee JH ，Kwon E ，Jung HY ，Choi JY ，Cho JH ，Park SH ，Kim YL ，Kim HK ，Huh S ，Kim CD ... -  《-》

Serum iron parameters in the early post-transplant period and infection risk in kidney transplant recipients.

The impact of iron metabolism on the risk of infectious complications has been demonstrated in various immunosuppressed populations. However, no previous studies have assessed this potential association in kidney transplant (KT) recipients. We prospectively analyzed 228 patients undergoing KT at our institution from November 2008 to February 2011. Serum iron parameters (iron level, ferritin, total iron-binding capacity, unsaturated iron-binding capacity, transferrin, and transferrin saturation) were assessed within the first 2 weeks after transplantation (median interval, 3 days; interquartile [Q1 -Q3 ] range, 1-6 days), and before the occurrence of the first infectious episode (median interval, 26 days; Q1 -Q3 range, 11-76 days). Primary outcome was the occurrence of any episode of infection during the first year. Multivariate-adjusted hazard ratios (aHRs) were estimated by Cox regression models. Patients with ferritin level ≥ 500 ng/mL had higher incidence rates (per 1000 transplant-days) of overall infection (P = 0.017), bacterial infection (P = 0.002), and bloodstream infection (P = 0.011) during the first post-transplant year. One-year infection-free survival rate was lower in these recipients (26% vs. 41%; P = 0.004). On multivariate analysis, after adjusting for potential confounders, ferritin emerged as an independent predictor of overall infection (aHR [per unitary increment], 1.001; P = 0.006), and bacterial infection (aHR [per unitary increment], 1.001; P = 0.020). Monitoring of serum iron parameters in the early post-transplant period may be useful in predicting the occurrence of infection in KT recipients, although further studies should be carried out to confirm this preliminary finding.

Fernández-Ruiz M ，López-Medrano F ，Andrés A ，Morales JM ，Lumbreras C ，San-Juan R ，Polanco N ，González E ，Aguado JM ... -  《-》

Blood transfusion and the risk for infections in kidney transplant patients.

Massicotte-Azarniouch D ，Sood MM ，Fergusson DA ，Chassé M ，Tinmouth A ，Knoll GA ... -  《PLoS One》