Cranberry Products May Stop UTIs

CRANBERRY PRODUCTS reduce the risk for symptomatic urinary tract infections (UTIs) in women with recurrent UTIs, in children, and in patients receiving interventions such as radiation therapy for bladder or prostate cancer, a recent review finds.

Elisabeth M. Hodson, MBBS, of The Children’s Hospital at Westmead in Australia, and colleagues conducted an updated systematic review of 50 randomized trials or quasi-randomized studies involving 8857 patients from multiple countries. In a metaanalysis of 26 studies, cranberry products significantly reduced the risk for symptomatic, culture‐verified UTIs by 30% compared with placebo or no treatment, the investigators reported in the Cochrane Database of Systematic Reviews Cranberry products significantly reduced the risk for UTIs by 26% in women with recurrent UTIs, 54% in children (without neurogenic bladder), and 53% in individuals susceptible to UTIs due to an intervention.

Event Rates Compared

Pneumonia/respiratory infections and urinary tract infections are among the most common adverse events in patients with nondialysis-dependent CKD (NDD-CKD) and prevalent and incident dialysis patients, with higher rates occurring in the dialysis groups.

particularly pneumonia/respiratory infection and UTI. In the NDD-CKD group, the most common AEs were pneumonia/respiratory infection (9.3) and UTI (8.2).

The hyperkalemia event rate was 0.67 per 100 person-years for the NDDCKD group compared with 4.4 and 5.0 per 100 person-years for the prevalent and incident dialysis groups, respectively. The rate of infection/sepsis was 1.0 per 100 person-years for the nondialysis group compared with 7.1 and 8.0 per 100 person-years in the prevalent and incident dialysis groups, respectively.

declined, the prevalence of comorbidities generally increased.

In the prevalent and incident dialysis groups, the most common AEs (rates per 100 person-years) were pneumonia/respiratory infection (18.0 and 19.9), urinary tract infection (UTI; 11.3

The certainty of the evidence was moderate.

Current data do not support the use of cranberry products in older adults residing in nursing homes and other long-term care facilities, patients with neuromuscular bladder dysfunction and incomplete bladder emptying, or pregnant women, Dr Hodson, editor of Cochrane Kidney and Transplant, and colleagues reported. Cranberry products included cranberry juice, tablets, capsules, or powder taken for at least 1 month. According to the investigators, cranberries contain proanthocyanidins that prevent adherence of Escherichia coli to urothelial cells lining the bladder walls. No formal proanthocyanidin dose, formulation, or regimen has been established for UTI prevention.

“This is a review of the totality of the evidence and as new evidence emerges, new findings might occur,” senior author Jonathan Craig, MBChB, PhD, vice president and executive dean of the College of Medicine & Public Health at Flinders University in Australia, stated in a news release. “In this case, the new evidence shows a very positive finding that cranberry juice can prevent UTI in susceptible people.” The investigators did not have sufficient data to determine whether cranberry products are more or less effective than probiotics or antibiotics in preventing UTI. ■ and 12.4), infection/sepsis (7.1 and 8.0), and seizure (1.05 and 1.14), respectively. Seizure occurred at a 3-fold higher rate in patients on dialysis compared with those with NDD-CKD. Overall, AE rates were higher among patients on hemodialysis than peritoneal dialysis,

“Collectively, the increased incidence of adverse clinical events likely reflects the higher comorbidity burden of patients on or transitioning to dialysis versus those with NDD-CKD,” Dr Little’s team wrote. They noted that the higher AE rates among patients on dialysis may be due to an increase in risk factors or monitoring and reporting. ■