Nickan Research Institute Journal of Renal Injury Prevention 2345-2781 14 2 2025 06 01 Renal transplant recipients and complicated UTIs: a path toward next-generation care e38423 e38423 10.34172/jrip.2025.38423 EN Rob E. Carpenter https://orcid.org/0000-0002-2818-7474 Journal Article 10.34172/jrip.2025.38423 2024 12 06 2025 01 21 Renal transplant recipients face a heightened risk of complicated urinary tract infections (cUTIs) due to immunosuppression, anatomical changes, and recurrent urinary abnormalities. Traditional diagnostic methods, including standard urine cultures, are often insufficient in identifying fastidious organisms and multidrug-resistant (MDR) pathogens that contribute to recurrent infections. Emerging technologies, such as next-generation sequencing (NGS), offer a novel, culture-independent approach that improves pathogen detection, especially in cases involving polymicrobial infections or rare microbes. This article explores the role of NGS in addressing diagnostic limitations for renal transplant patients with cUTIs, highlighting its capacity to identify both bacterial and viral pathogens and their resistance profiles. The clinical relevance of NGS in enhancing treatment precision and improving graft outcomes is discussed, emphasizing the potential for reduced nephrotoxic effects from broad-spectrum antibiotics. As the incidence of antimicrobial resistance rises, advanced diagnostic solutions like NGS offer a promising path for optimizing post-transplant care and safeguarding graft function.