BACKGROUND: Febrile urinary tract infections (fUTIs) are common after kidney transplantation (KTx); however, prospective data in a multicenter pediatric cohort are lacking. We designed a prospective registry to record data on fUTI before and after pediatric KTx. METHODS: Ninety-eight children (58 boys and 40 girls) ≤ 18 years from 14 mid-European centers received a kidney transplant and completed a 2-year follow-up. RESULTS: Posttransplant, 38.7% of patients had at least one fUTI compared with 21.4% before KTx (p = 0.002). Before KTx, fUTI was more frequent in patients with congenital anomalies of kidneys and urinary tract (CAKUT) vs. patients without (38% vs. 12%; p = 0.005). After KTx, fUTI were equally frequent in both groups (48.7% vs. 32.2%; p = 0.14). First fUTI posttransplant occurred earlier in boys compared with girls: median range 4 vs. 13.5 years (p = 0.002). Graft function worsened (p < 0.001) during fUTI, but no difference was recorded after 2 years. At least one recurrence of fUTI was encountered in 58%. CONCLUSION: This prospective study confirms a high incidence of fUTI after pediatric KTx, which is not restricted to patients with CAKUT; fUTIs have a negative impact on graft function during the infectious episode but not on 2-year graft outcome.

2nd School of Medicine University Hospital Motol Charles University Prague Prague Czech Republic

Children's Hospital Memmingen Memmingen Germany

Department of Nephrology University Children's Hospital Zurich Switzerland

Department of Pediatrics 1 University Children's Hospital Heidelberg Germany

Department of Pediatrics 1 University Medical Center Innsbruck Innsbruck Austria

Pediatric Nephrology Children's Hospital St Georg Leipzig Germany

Pediatric Nephrology Hannover Medical School Hannover Germany

Pediatric Nephrology University Children's Hospital Freiburg Germany

Pediatric Nephrology University Children's Hospital Rostock Germany

Pediatric Nephrology University Childrens Hospital University Medical Center Hamburg Eppendorf Hamburg Germany

Pediatric Nephrology University Medical Center Bonn Bonn Germany

Pediatric Nephrology University Medical Center Jena Kochstrasse 2 07743 Jena Germany

Pediatric Nephrology University Medical Center Münster Münster Germany

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