Cytomegalovirus disease in renal transplant recipients. The diagnostic presumption based on the clinical method
Keywords:
cytomegalovirus disease, renal transplantation, ganciclovirAbstract
Introduction: cytomegalovirus disease represents a threat to immunosuppressed patients and, in particular, to renal transplant recipients.
Objective: to describe the evolution of renal transplant recipients with presumptive diagnosis of cytomegalovirus disease and empirical treatment regimen.
Methods: longitudinal, prospective and exploratory study that included 81 adult renal transplant recipients with presumptive diagnosis of cytomegalovirus disease divided into two groups: younger (17, 20.98%) and older than one year post-graft evolution (64, 79.01%), with clinical and laboratory evaluations and treatment with intravenous ganciclovir. Non-parametric tests, bivariate correlations, binomial test and Mann Whitney U test were used.
Results: mean age 48.46±11.10 years, male sex and white skin color prevailed. Dyspnea was more frequent in both groups. Neutrophil count, platelet count and glutamic pyruvic glutamic transaminase value were not significant (p˃0.05). Serum creatinine values of ≥170 μMol/l predominated: 294±143.18 and 283.59±146.55 respectively (p=0.040). Symptom onset was similar: 5.88±2.18 and 5.78±2.00 days with no significant differencesand hospital stay was shorter in those older than one year -25.92±10.78 (p=0.029)-. The most frequent serological status for cytomegalovirus was donor (-) recipient (-). Nine patients died, four (23.52%) less than one year post-grafting. The enteropathic form was the most common; the coinfection was urinary tract infection and the complication was acute allograft dysfunction.
Conclusions: the use of the clinical method and the early initiation of treatment were effective in the diagnostic and therapeutic definition of cytomegalovirus disease.
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