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  3. 32. Urinary Tract Infections in Chronic Kidney Disease Investigating Recurrent UTIs in CKD and Their Impact on Disease Progression and Management
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32. Urinary Tract Infections in Chronic Kidney Disease Investigating Recurrent UTIs in CKD and Their Impact on Disease Progression and Management

Original Article

Impact of Recurrent UTIs on CKD Outcomes and various management strategies

Urinary Tract Infections in Chronic Kidney Disease Investigating Recurrent UTIs in CKD and Their Impact on Disease Progression and Management

Zafar Ahmad Khan, Rizwan Kundi and Adnan Akhtar

ABSTRACT

Objective:This study investigates the impact of recurrent UTIs on CKD outcomes and evaluates various management strategies.

Study Design:A prospective, observational, cross-sectional study.

Place and Duration of Study: This study was conducted at theDepartment of Urology, at Bacha Khan Medical College & Mardan Medical Complex Mardan from July 2023 to June 2024.

Methods:A total of 245 CKD patients were enrolled, with a mean age of 65.4 ± 10.2 years. Demographic and clinical data, including CKD stage, comorbidities, and UTI history, were collected. The number of UTI episodes, causative organisms, antibiotic resistance patterns, and management outcomes were also analyzed.

Results:Recurrent UTIs were present in 61.2% of patients. Those with recurrent UTIs showed significantly faster eGFR decline (4.8 ± 1.2 vs. 2.1 ± 1.0 mL/min/year, p < 0.001) and increased serum creatinine levels (1.1 ± 0.5 vs. 0.5 ± 0.3 mg/dL, p < 0.001) compared to those without recurrent UTIs. Furthermore, recurrent UTI patients had higher rates of progression to ESRD (33.3% vs. 15.8%, p = 0.002), dialysis need (26.7% vs. 10.5%, p = 0.005), and mortality (16.7% vs. 8.4%, p = 0.03). The most common causative organism was Escherichia coli (65.3%), and 24.5% of bacterial strains were ESBL-producing. Management strategies, including empirical and targeted antibiotic use, showed varied success rates, with targeted therapy being most effective (88.2% improvement).

Conclusion:Recurrent UTIs significantly worsen CKD progression and increase the risk of adverse outcomes. Effective management, particularly targeted antibiotic therapy, is crucial for improving patient outcomes in this high-risk population.

Key Words:Urinary tract infection, chronic kidney disease, recurrent UTIs, eGFR, progression to ESRD, antibiotic resistance, management strategies, mortality.

Citation of article:Khan ZA, Kundi R, AkhtarA. Urinary Tract Infections in Chronic Kidney Disease Investigating Recurrent UTIs in CKD and Their Impact on Disease Progression and Management.Med Forum2024;35(12):147-151.doi:10.60110/medforum.351232.