Advanced search
Start date
Betweenand
Related content
(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

A high level of urinary retinol-binding protein is associated with cytomegalovirus infection in kidney transplantation

Full text
Author(s):
Requiao-Moura, Lucio R. [1, 2] ; Matos, Ana C. C. [2] ; Ozaki, Kikumi S. [2] ; Camara, Niels O. S. [3, 1] ; Pacheco-Silva, Alvaro [1, 2]
Total Authors: 5
Affiliation:
[1] Univ Fed Sao Paulo, Dept Med, Nephrol Div, Sao Paulo - Brazil
[2] Hosp Israelita Albert Einstein, Renal Transplantat Div, Sao Paulo - Brazil
[3] Univ Sao Paulo, Inst Biomed Sci, Dept Immunol, Sao Paulo - Brazil
Total Affiliations: 3
Document type: Journal article
Source: Clinical Science; v. 132, n. 18, p. 2059-2069, SEP 28 2018.
Web of Science Citations: 0
Abstract

The indirect effects of cytomegalovirus (CMV) viremia can be related to chronic changes in renal allograft structure, but its real impact in early and late graft function remains speculative. A total of 159 patients undergoing renal transplantation using a preemptive therapeutic strategy to prevent CMV disease were included in the present study. The patients were prospectively followed, with serial measurements of urinary retinol-binding protein (uRBP), a marker of proximal tubule injury. uRBP levels and their dynamic performance were compared according to CMV viremia and the 5-year estimated glomerular filtration rate (eGFR), as measured with the modification of diet in renal disease (MDRD) equation. CMV viremia was detected in 79.9% of the patients, with high uRBP levels being detected in 76.0% of these patients (compared with 40.7% in CMV-, P=0.005). High uRBP was associated with male recipients (P=0.02), the number of mismatches (P=0.02) and CMV infection (P=0.001). Five-year eGFR was worse in patients with high uRBP levels (50.3 +/- 25.8 compared with 59.8 +/- 26.4 ml/min, P=0.04). In a multivariate model, eGFR r 60 ml/min was associated with donor age (P<.0.001), the number of mismatches (P=0.04), thymoglobulin dose (P=0.02), the presence of and time with delayed graft function (DGF) (P=0.005 and P=0.04), 1-month tacrolimus levels (P=0.03), and uRBP levels after CMV treatment (P=0.01). Patients with CMV viremia in whom uRBP levels were normalized up to 3 months after treatment showed significantly better 5-year eGFR than those in whom uRBP remained high: 61.0 +/- 24.2 compared with 42.3 +/- 23.9 ml/min, P < 0.001. CMV viremia was associated with high uRBP levels, which represent a profile of proximal tubule injury, and the dynamic performance of uRBP after treatment was associated with long-term kidney graft function. (AU)

FAPESP's process: 17/05264-7 - Cell metabolism, microbiota and immune system: new paradigms in renal diseases physiopathology
Grantee:Niels Olsen Saraiva Câmara
Support type: Research Projects - Thematic Grants