Causes of hospitalisation during the first year after kidney transplatation

Transplantacija bubrega je metoda izbora nadomještanja bubrežne funkcije za većinu bolesnika s kroničnom bubrežnom bolešću. Omogućuje bolju kvalitetu života i nisku smrtnost u odnosu na bolesnike na dijalizi. Jednogodišnje preživljenje bolesnika nakon transplantacije bubrega iznosi preko 90%. Komplikacije kao što su infekcije, odbacivanje presatka bubrega i kronična disfunkcija presatka dovode do lošijih ishoda i hospitalizacija bolesnika. Osim što negativno utječe na bolesnikovo fizičko i psihičko blagostanje, dokazana ja veća smrtnost u odnosu na bolesnike bez hospitalizacije. Rano razdoblje nakon transplantacije bubrega povezano je s rizikom od brojnih komplikacija koje zahtijevaju hospitalizaciju bolesnika nakon transplantacije bubrega. Hipoteza istraživanja je da su u prvoj godini nakon transplantacije bubrega najčešći uzrok hospitalizacije infekcije. Ciljevi istraživanja su utvrditi koje vrsta infekcije je najčešću uzrok hospitalizacije, te utvrditi postojanje rizičnih čimbenika koji utječu na učestalost infekcija u prvoj godini nakon transplantacije bubrega. Istraživanje je provedeno u Zavodu za nefrologiju Kliničke bolnice Merkur na uzorku od 107 ispitanika. Provedena je retrospektivna analiza dokumentacije i podataka Bolničkog informacijskog sustava. Dobivenim rezultatima utvrđeno je da su najčešći uzrok hospitalizacija infekcije u 63,6% ispitanika, a najčešći razlog za hospitalizaciju u prvoj godini nakon transplantacije bubrega su infekcije mokraćnog sustava u 31,8% ispitanika. Statističkom obradom potencijalnih rizičnih čimbenika utvrđeno je da su epizode odbacivanja presatka bubrega povezane s rizikom od nastanka infekcija kao i infekcija mokraćnog sustava, te ženski spol za infekcije mokraćnog sustava. Rezultati ovog istraživanja mogu se upotrijebiti u pre-transplantacijskom probiru bolesnika s visokim rizikom za nastanak infekcija, kao i u edukaciji i praćenju bolesnika nakon transplantacije bubrega s ciljem prevencije, ranog dijagnosticiranja i liječenja infekcija što može doprinijeti smanjenju broja hospitalizacija u prvoj godini nakon transplantacije bubrega.Kidney transplantation is the best method of treatment for most patients with chronic kidney disease. It provides a better quality of life and low mortality compared to dialysis patients. The one-year survival of patients after kidney transplantation is over 90%. Complications such as infections, kidney transplant rejection, and chronic renal failure lead to poor outcomes and hospitalizations of patients. Hospitalizations are negatively affecting the patient's physical and mental well-being and higher mortality has been proven compared to patients without hospitalization. Early period after kidney transplantation is associated with risk of a number of complications that require hospitalization of patients after kidney transplantation. The research hypothesis is that in the first year after kidney transplantation, the most common cause of hospitalization are infections. The objectives of the study are to determine which type of infection is the most common cause of hospitalization, and to determine the existence of risk factors that affect the frequency of infections in the first year after kidney transplantation. The research was conducted in the Department of Nephrology of the Clinical Hospital Merkur on a sample of 107 subjects. A retrospective analysis of the documentation and data of the Hospital Information System was performed. The obtained results showed that the most common cause of hospitalization are infections in 63.6% of subjects, and the most common cause that require hospitalization in the first year after kidney transplantation are urinary tract infections in 31.8% of subjects. Statistical analysis of potential risk factors found that episodes of kidney transplant rejection were associated with the risk of infections as well as urinary tract infections, and female gender for urinary tract infections. The results of this study can be used in pre-transplant screening of patients at high risk for infections, as well as in education and monitoring of patients after kidney transplantation with the aim of prevention, early diagnosis and treatment of infections, which can reduce hospitalizations in the first year after kidney transplantation