Aim: Kidney transplant patients are amongst the high-risk groups for severe Covid 19. To date, no specific antiviral agent has been found uniformly effective against severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Favipiravir, the recommended drug by The Turkish Ministry of Health, was uniformly supplied to all patients diagnosed to have COVID 19 with a positive nasopharyngeal swap PCR test. The aim of our study was to retrospectively compare our kidney transplant recipients who developed COVID-19 infection started on Favipiravir to those who did not use Favipiravir for the clinical course of the disease with a special emphasis on the occurrence of side effects/adverse events. Methods: Thirty-seven consecutive KT recipients with a median age of 46 years and of whom 62.2% were women; 8 deceased /29 living related donor, with a 8.0 (5.5-12.5) years median duration of transplantation were included in the study. Results: Twenty-six (70.3%) patients received Favipiravir, 11(29.7%) did not. There was no statistical significance in baseline demographic, clinical and laboratory findings between the groups except that the Favipiravir group was older and had a higher requirement of oxygen treatment. There was no statistically significant difference in the course and outcome of COVID-19 infection, in the occurrence of side effects/adverse events related to Favipiravir between the two groups. Laboratory data at baseline, day7 and 30 were also comparable between the groups. Conclusion: Although the efficacy of Favipiravir in the treatment of COVID-19 infection is currently controversial, Favipiravir can safely be used in kidney transplant patients.

Purpose: Kidney transplant recipients are prone to metabolic bone diseases and consequent fractures. This study aimed to evaluate the incidence of incipient vertebral fractures, osteopenia, osteoporosis, and the clinical factors associated with incipient vertebral fractures in a group of kidney transplant patients. Methods: Two hundred sixty-four patients (F/M:124/140, 45.3±13 years) who had undergone kidney transplantation between 2008 and 2018 and who were followed up at least one year in third care centers were included in this multicenter retrospective study. Bone mineral densitometry was performed using dual-energy X-ray absorptiometry. Vertebral fractures were assessed semi-quantitatively using conventional thoracolumbar lateral radiography in 202 of the patients. Results: Vertebral fractures were observed in 56.4% (n=114) of the study group. Severe vertebral fractures were observed in 30.7% (n=62) of the patients in vertebral X-ray evaluation. The frequency of osteoporosis was 20.0% (53 of 264 patients), and osteopenia was 35.6% (94 of 264 patients). BMD levels were in the normal range in 40.3% (n=46) of the subjects with vertebral fractures. It was in the osteoporotic range in 20.1% (n=23) and the osteopenic range in 40.3% (n=46). Serum calcium, parathormone vitamin, and creatinine levels were similar between the patients with and without vertebral fractures. Femoral neck BMD was negatively correlated with age (r: −0.21, p<0.001) and positively correlated with body mass index (r:0.29, p<0.001). Vertebral fractures were associated with age, duration of hemodialysis, BMI, femoral neck Z score (R2: 37.8%, p=0.027). Conclusion: BMD was in the normal or osteopenic range in 79.8% in our cohort of renal transplant patients with incipient vertebral fractures. As incipient vertebral fractures can be observed in patients with normal BMD levels in kidney transplant recipients, conventional X-ray screening for vertebral fractures may be beneficial for a proper therapy decision of metabolic bone disease in kidney transplant recipients.

Background: The most common infections among renal transplant patients are urinary tract infections (UTI). Our main objective in this study is to determine the incidence of UTIs in patients who have undergone renal transplantation in our hospital, to identify the causative microbiological agents, risk factors and determine the effects of UTI on short-term graft survival. Methods: Adult patients, who underwent renal transplantation between October 2011 and July 2018, were included in this study. Urinary tract infections which developed within the first year of renal transplantation were investigated. Patients were compared regarding demographic, clinical, laboratory characteristics, and graft survival. Results: 102 patients were included in our study. Forty patients (51.9%) were male and 37 (48.1%) were female. Sixty-seven urinary tract infection attacks in 21 patients were recorded. Age (p=0.009; 95% Confidence Interval [CI]: 1.014-1.105), longer indwelling urinary catheter stay time (p=0.027; 95% Confidence Interval [CI]: 1.010-1.174) and urologic complications (p=0.032; 95% Confidence Interval [CI]: 0.094-0.896) were found as risk factors for UTI development in the first year of transplantation. Escherichia coli and Klebsiella pneumoniae were the most frequently isolated microorganisms. Of these bacteria, 63.2 % were found to be extended spectrum beta lactamase (ESBL) positive. Resistant microorganisms were more frequent in male patients (31 episodes in males vs. 12 episodes in females, p=0.0015). UTI had no negative impact on short-term graft survival. Conclusion: Patients with advanced age, who had a longer duration of bladder catheterization and urologic complications should be followed carefully regarding UTI. Since there is a high incidence of UTI in male transplant patients, more frequently caused by resistant microorganisms, infection control methods should be applied more vigorously especially in male transplant patients.