High human cytomegalovirus DNAemia early post‐transplantation associates with irreversible and progressive loss of renal function – a retrospective study

Summary Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human cytomegalovirus (CMV) DNAemia on transplant renal function. A total of 264 (age 50.9 ± 13.5; male 55%) renal transplantation recipients unde...

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Published inTransplant international Vol. 30; no. 8; pp. 817 - 826
Main Authors Lollinga, Wouter T., Rurenga‐Gard, Lilli, Doesum, Willem, Bergen, Rik, Diepstra, Arjan, Vonk, Judith M., Riezebos‐Brilman, Annelies, Niesters, H. G. M., Son, Willem J., Born, Jacob, Sanders, Jan‐Stephan
Format Journal Article
LanguageEnglish
Published England Frontiers Media SA 01.08.2017
Subjects
Adult
Cytomegalovirus
Cytomegalovirus - genetics
Cytomegalovirus Infections - blood
Cytomegalovirus Infections - etiology
Cytomegalovirus Infections - virology
DNA, Viral - blood
DNA, Viral - genetics
Epidermal growth factor receptors
estimated glomerular filtration rate
Female
Glomerular Filtration Rate
human cytomegalovirus
Humans
Infections
Kidney - physiopathology
Kidney transplantation
Kidney Transplantation - adverse effects
Male
Middle Aged
Peak load
Preempting
Regression analysis
Renal function
Retrospective Studies
Statistical analysis
Time Factors
Transplantation
Transplants & implants
viral infection
Viral infections
Viral Load
Viremia - blood
Viremia - etiology
Viremia - virology
renal function
viral infection
estimated glomerular filtration rate
human cytomegalovirus
kidney transplantation
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Abstract Summary Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human cytomegalovirus (CMV) DNAemia on transplant renal function. A total of 264 (age 50.9 ± 13.5; male 55%) renal transplantation recipients undergoing preemptive anti‐CMV therapy were retrospectively categorized based on early (<3 months post‐Tx) CMV peak viral load (PVL); PVL ≤ 536, PVL536–6310, or PVL > 6310 International Units/ml (IU/ml). Estimated glomerular filtration rate (eGFR) was analyzed between 1 and 36 months post‐transplantation with Kruskal–Wallis test, linear regression, and a linear mixed‐effects model. CMV infection was detectable in 113 (43%) recipients within 49 [38–67] days. Subjects with PVL > 6310 had statistically significant ~5–13 ml/min lower eGFR between 3 and 36 months compared to PVL ≤ 536 and PVL536–6310. eGFR declined from 46.1 to 40.7 ml/min/1.73 m2 (−12%) over 3 years, and the annual decrease for pronounced infection with high PVL was 2.0 ml/min/1.73 m2 faster than for noninfected or mildly infected subjects. In conclusion, high CMV DNAemia early after renal transplantation was associated with significant loss of renal function, from which subjects did not recover. The severity of infection (high PVL early post‐transplantation), more than the infection per se, was related to irreversible and progressive loss of renal function.
AbstractList Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human cytomegalovirus (CMV) DNAemia on transplant renal function. A total of 264 (age 50.9 ± 13.5; male 55%) renal transplantation recipients undergoing preemptive anti-CMV therapy were retrospectively categorized based on early (<3 months post-Tx) CMV peak viral load (PVL); PVL ≤ 536, PVL536-6310, or PVL > 6310 International Units/ml (IU/ml). Estimated glomerular filtration rate (eGFR) was analyzed between 1 and 36 months post-transplantation with Kruskal-Wallis test, linear regression, and a linear mixed-effects model. CMV infection was detectable in 113 (43%) recipients within 49 [38-67] days. Subjects with PVL > 6310 had statistically significant ~5-13 ml/min lower eGFR between 3 and 36 months compared to PVL ≤ 536 and PVL536-6310. eGFR declined from 46.1 to 40.7 ml/min/1.73 m (-12%) over 3 years, and the annual decrease for pronounced infection with high PVL was 2.0 ml/min/1.73 m faster than for noninfected or mildly infected subjects. In conclusion, high CMV DNAemia early after renal transplantation was associated with significant loss of renal function, from which subjects did not recover. The severity of infection (high PVL early post-transplantation), more than the infection per se, was related to irreversible and progressive loss of renal function.
Summary Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human cytomegalovirus (CMV) DNAemia on transplant renal function. A total of 264 (age 50.9 ± 13.5; male 55%) renal transplantation recipients undergoing preemptive anti-CMV therapy were retrospectively categorized based on early (<3 months post-Tx) CMV peak viral load (PVL); PVL ≤ 536, PVL536-6310, or PVL > 6310 International Units/ml (IU/ml). Estimated glomerular filtration rate (eGFR) was analyzed between 1 and 36 months post-transplantation with Kruskal-Wallis test, linear regression, and a linear mixed-effects model. CMV infection was detectable in 113 (43%) recipients within 49 [38-67] days. Subjects with PVL > 6310 had statistically significant ~5-13 ml/min lower eGFR between 3 and 36 months compared to PVL ≤ 536 and PVL536-6310. eGFR declined from 46.1 to 40.7 ml/min/1.73 m2 (-12%) over 3 years, and the annual decrease for pronounced infection with high PVL was 2.0 ml/min/1.73 m2 faster than for noninfected or mildly infected subjects. In conclusion, high CMV DNAemia early after renal transplantation was associated with significant loss of renal function, from which subjects did not recover. The severity of infection (high PVL early post-transplantation), more than the infection per se, was related to irreversible and progressive loss of renal function.
Summary Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human cytomegalovirus (CMV) DNAemia on transplant renal function. A total of 264 (age 50.9 ± 13.5; male 55%) renal transplantation recipients undergoing preemptive anti‐CMV therapy were retrospectively categorized based on early (<3 months post‐Tx) CMV peak viral load (PVL); PVL ≤ 536, PVL536–6310, or PVL > 6310 International Units/ml (IU/ml). Estimated glomerular filtration rate (eGFR) was analyzed between 1 and 36 months post‐transplantation with Kruskal–Wallis test, linear regression, and a linear mixed‐effects model. CMV infection was detectable in 113 (43%) recipients within 49 [38–67] days. Subjects with PVL > 6310 had statistically significant ~5–13 ml/min lower eGFR between 3 and 36 months compared to PVL ≤ 536 and PVL536–6310. eGFR declined from 46.1 to 40.7 ml/min/1.73 m2 (−12%) over 3 years, and the annual decrease for pronounced infection with high PVL was 2.0 ml/min/1.73 m2 faster than for noninfected or mildly infected subjects. In conclusion, high CMV DNAemia early after renal transplantation was associated with significant loss of renal function, from which subjects did not recover. The severity of infection (high PVL early post‐transplantation), more than the infection per se, was related to irreversible and progressive loss of renal function.
Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human cytomegalovirus (CMV) DNAemia on transplant renal function. A total of 264 (age 50.9 ± 13.5; male 55%) renal transplantation recipients undergoing preemptive anti-CMV therapy were retrospectively categorized based on early (<3 months post-Tx) CMV peak viral load (PVL); PVL ≤ 536, PVL536-6310, or PVL > 6310 International Units/ml (IU/ml). Estimated glomerular filtration rate (eGFR) was analyzed between 1 and 36 months post-transplantation with Kruskal-Wallis test, linear regression, and a linear mixed-effects model. CMV infection was detectable in 113 (43%) recipients within 49 [38-67] days. Subjects with PVL > 6310 had statistically significant ~5-13 ml/min lower eGFR between 3 and 36 months compared to PVL ≤ 536 and PVL536-6310. eGFR declined from 46.1 to 40.7 ml/min/1.73 m2 (-12%) over 3 years, and the annual decrease for pronounced infection with high PVL was 2.0 ml/min/1.73 m2 faster than for noninfected or mildly infected subjects. In conclusion, high CMV DNAemia early after renal transplantation was associated with significant loss of renal function, from which subjects did not recover. The severity of infection (high PVL early post-transplantation), more than the infection per se, was related to irreversible and progressive loss of renal function.Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human cytomegalovirus (CMV) DNAemia on transplant renal function. A total of 264 (age 50.9 ± 13.5; male 55%) renal transplantation recipients undergoing preemptive anti-CMV therapy were retrospectively categorized based on early (<3 months post-Tx) CMV peak viral load (PVL); PVL ≤ 536, PVL536-6310, or PVL > 6310 International Units/ml (IU/ml). Estimated glomerular filtration rate (eGFR) was analyzed between 1 and 36 months post-transplantation with Kruskal-Wallis test, linear regression, and a linear mixed-effects model. CMV infection was detectable in 113 (43%) recipients within 49 [38-67] days. Subjects with PVL > 6310 had statistically significant ~5-13 ml/min lower eGFR between 3 and 36 months compared to PVL ≤ 536 and PVL536-6310. eGFR declined from 46.1 to 40.7 ml/min/1.73 m2 (-12%) over 3 years, and the annual decrease for pronounced infection with high PVL was 2.0 ml/min/1.73 m2 faster than for noninfected or mildly infected subjects. In conclusion, high CMV DNAemia early after renal transplantation was associated with significant loss of renal function, from which subjects did not recover. The severity of infection (high PVL early post-transplantation), more than the infection per se, was related to irreversible and progressive loss of renal function.
Author Rurenga‐Gard, Lilli
Son, Willem J.
Niesters, H. G. M.
Born, Jacob
Doesum, Willem
Sanders, Jan‐Stephan
Riezebos‐Brilman, Annelies
Bergen, Rik
Vonk, Judith M.
Lollinga, Wouter T.
Diepstra, Arjan
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Issue 8
Keywords renal function
viral infection
estimated glomerular filtration rate
human cytomegalovirus
kidney transplantation
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Snippet Summary Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human...
Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human...
Summary Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human...
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crossref
wiley
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StartPage 817
SubjectTerms Adult
Cytomegalovirus
Cytomegalovirus - genetics
Cytomegalovirus Infections - blood
Cytomegalovirus Infections - etiology
Cytomegalovirus Infections - virology
DNA, Viral - blood
DNA, Viral - genetics
Epidermal growth factor receptors
estimated glomerular filtration rate
Female
Glomerular Filtration Rate
human cytomegalovirus
Humans
Infections
Kidney - physiopathology
Kidney transplantation
Kidney Transplantation - adverse effects
Male
Middle Aged
Peak load
Preempting
Regression analysis
Renal function
Retrospective Studies
Statistical analysis
Time Factors
Transplantation
Transplants & implants
viral infection
Viral infections
Viral Load
Viremia - blood
Viremia - etiology
Viremia - virology
Title High human cytomegalovirus DNAemia early post‐transplantation associates with irreversible and progressive loss of renal function – a retrospective study
URI https://onlinelibrary.wiley.com/doi/abs/10.1111%2Ftri.12972
https://www.ncbi.nlm.nih.gov/pubmed/28432714
https://www.proquest.com/docview/1921100688
https://www.proquest.com/docview/1891144215
Volume 30
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