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Kidney function of Japanese children undergoing kidney transplant with preemptive therapy for cytomegalovirus infection
Author(s) -
Gotoh Yoshimitsu,
Shishido Seiichiro,
Hamasaki Yuko,
Watarai Yoshihiko,
Hattori Motoshi,
Miura Kenichiro,
Ishizuka Kiyonobu,
Fujita Naoya,
Saito Kazuhide,
Nakagawa Yuki,
Hotta Kiyohiko,
Hataya Hiroshi,
Hamada Riku,
Sato Hiroyuki,
Kitayama Hirotsugu,
Ishikura Kenji,
Honda Masataka,
Uemura Osamu
Publication year - 2020
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13271
Subject(s) - medicine , cytomegalovirus , viremia , renal function , kidney disease , kidney transplantation , adverse effect , human cytomegalovirus , immunology , kidney , gastroenterology , viral disease , virus , herpesviridae
Background Cytomegalovirus (CMV) infection is one of the major factors that affect morbidity and mortality in kidney transplant (KTx) patients. The rate of CMV seropositivity in children before KTx is lower than that in adults; therefore, pediatric KTx patients have a higher risk of CMV infection. In Japanese pediatric KTx patients, preemptive therapy for CMV infection is a main conventional therapy. This study investigated whether this preemptive treatment would affect kidney function at 2 years post‐KTx. Methods A total of 163 patients, that is approximately half of the Japanese pediatric KTx patients nationwide, were recruited to participate in our study. We compared the values of the sequential estimated glomerular filtration rate (eGFR) at two years post‐KTx and other influencing factors in CMV viremia, CMV disease, and no‐infection groups. Results Cytomegalovirus infection after KTx occurred in 75 patients (46.0%), 38.7% of whom developed CMV disease. The sequential eGFR values post‐KTx did not differ significantly between the three groups. CMV infection was not significantly correlated with other factors, other infections (including Epstein‐Barr [EB] virus infection), acute rejection (AR), or adverse events. Only prolonged duration of total hospitalization was significantly associated with CMV infection ( P = .002). In the multivariate analysis, younger age, CMV infection, and adverse effects were independently significantly related to prolonged total hospitalization. Conclusion Preemptive therapy for CMV infection evidenced by viremia and disease did not significantly influence kidney function in Japanese pediatric KTx patients at two years after the operation.