1. ¹Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, Minnesota, USA
2. ²Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, Minnesota, USA
3. ³Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
4. ⁴Pharmacovigilance, Bristol-Myers Squibb Company, Princeton, New Jersey, USA

Correspondence: Jon J. Snyder, Chronic Disease Research Group, Minneapolis Medical Research Foundation, 914 South 8th Street, Suite S-406, Minneapolis, Minnesota 55404, USA. E-mail: jsnyder@cdrg.org

Received 29 February 2008; Revised 24 September 2008; Accepted 9 October 2008; Published online 19 November 2008.

Abstract

We studied the incidence, trends and clinical correlates of infections following kidney transplantation in the United States Renal Data System over the years 1995–2003 in 46,471 adults with Medicare primary coverage at the time of their first kidney transplant. The incidence of most infections has declined only slightly since 1995 but infection with cytomegalovirus significantly declined while that with hepatitis C significantly increased. Relative frequencies of different types of infections (bacterial, viral, fungal and parasitic) were relatively constant, both during early and late periods following transplant. Using the Cox proportional hazards analysis we found that the clinical correlates for post-transplant bacterial and viral infections included older age, female gender, diabetes as the cause of end-stage renal disease, deceased (vs. living) donor source, time on dialysis before transplant, hepatitis B and C viral pre-transplant serologic status and pre-transplant donor-recipient cytomegalovirus serology. Our study shows that despite identifiable risk factors, the incidence of most post-transplant infections has changed little since 1995.