INTRODUCTION: The indirect effects of CMV infection can be related with IF/TA in renal transplants. The aims of this work are to evaluate the impact of CMV infection in a marker of early proximal tubular injury and in the renal graft function. METHODOLOGY: 159 patients undergoing renal transplantation were followed prospectively with serial measurements of urinary RBP (uRBP in mg/l) and creatinine clearance (Cockcroft-Gault in ml/min) and analyzed according CMV infection. RESULTS: CMV infection incidence was 72.9%. There were no differences on demographic data according CMV infection. However, a tendency of a higher number of male donors (52.6% vs. 44.2%, p=0.09) and recipients of grafts from older donors (41.1±13.1 vs. 37.0±13.2 yrs, p=0.10) were observed among infected patients. DGF, acute rejection, graft loss and death were similar. uRBP was similar according CMV infection: 6.4±9.5 in CMV+ vs. 9.9±43.8, p=0.45. Among the infected patients, 81.8% had elevated uRBP at the time of CMV diagnosis, versus 30.5% (p=0.013) of patients without infection. uRBP levels were found to increase markedly among infected patients at time of diagnosis: rising from 6.4±9.5 to 16.9±41.1, p=0.006. Over a similar time period, patients not infected had significantly lower levels of uRBP compared with infected patients at time of diagnosis: 1.9±1.5 vs. 16.9±41.1, p=0.025. Three months after transplant, the higher uRBP seen in infected patients compared to uninfected patients persisted: 4.7±8.6 vs. 1.7±2.1, p=0.041. Infected patients had creatinine clearance values of 58.2±23,2, 59.2±25.1 and 61.3±23.1 after one, two and three years, respectively, while uninfected patients had values of 67.3±25.6 (p=0.04), 73.4±32.8 (p= 0.006) and 73.3±33.2 (p=0.033). CONCLUSION: the CMV infection is associated with a profile of the proximal tubule injury assessed by measurements of urinary RBP, which is a very sensitive marker for this type of injury, as well as lower renal graft function until 3 years of follow up.
To cite this abstract in AMA style:Requião-Moura L, Tonato E, Matos A, Arruda E, Chinen R, Filiponi T, jr MDurão, Pacheco-Silva A. Early Tubular Injury and Late Graft Dysfunction Associated with Cytomegalovirus Infection in Kidney Transplants [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/early-tubular-injury-and-late-graft-dysfunction-associated-with-cytomegalovirus-infection-in-kidney-transplants/. Accessed May 9, 2021.
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