HOSPITALIZATIONS AFTER RENAL TRANSPLANTATION IN CHILDREN: RISK FACTORS, CAUSES AND OUTCOMES.

Introduction The aim of this study is to evaluate the frequency and causes of hospitalizations in the post-transplant period of children, to investigate the risk factors, and evaluate the relationship between hospitalizations and renal prognosis in the long term. Methods We retrospectively reviewed the files of pediatric renal transplant patients, followed at least 6 months after kidney transplantation, in our center. Clinical information including age at transplantation, gender, primary disease, donor type, immuno-suppressive medication, hospitalization dates and indications (infections and non-infectious) during follow-up period and graft outcomes were recorded. Results A total of 74 children (46 males) were followed up for a median of 54 months. Among them 69 patients (93.2%) were hospitalized 446 times. The most common cause of hospitalizations was infections (314 times, 70%). Urinary tract infections were the most important cause followed by upper respiratory tract infections. Forty (54%) patients were hospitalized 132 times (29.5%) for non-infectious reasons. The most common non infectious reason was nonspecific graft dysfunction (19 patients, 30 times), followed by rejection (17 patients, 27 times). Younger age, use of induction therapy and having congenital anomalies of kidney and urinary tract (CAKUT) were found to be risk factors for increased hospitalization rates (p<0.05). The number of hospitalizations were found to be negatively affected the final glomerular filtration rate of transplant recipients (p:0.04, r:-0.023). Conclusion Patients with CAKUT, who received induction therapy and small children were hospitalized more frequently after transplantation. Strategies to prevent hospitalizations will achieve a better graft prognosis.