The Association Between Cytomegalovirus Infection and Kidney Damage in the Liver Transplant Setting

Introduction: The development of chronic kidney disease (CKD) is a common and significant complication, contributing to morbidity after liver transplantation (LT). Cytomegalovirus (CMV) infection is common in the overall population, and relevant reinfection after LT may occur. CMV-associated kidney...

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Main Authors: Ramin Raul Ossami Saidy, Franziska Eurich, Brigitta Globke, Wenzel Schöning, Robert Öllinger, Nathanael Raschzok, Johann Pratschke, Dennis Eurich, Luca Dittrich, Eva Maria Dobrindt
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Language:English
Published: MDPI AG 2024-11-01
Series:Viruses
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Online Access:https://www.mdpi.com/1999-4915/16/12/1830
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author Ramin Raul Ossami Saidy
Franziska Eurich
Brigitta Globke
Wenzel Schöning
Robert Öllinger
Nathanael Raschzok
Johann Pratschke
Dennis Eurich
Luca Dittrich
Eva Maria Dobrindt
author_facet Ramin Raul Ossami Saidy
Franziska Eurich
Brigitta Globke
Wenzel Schöning
Robert Öllinger
Nathanael Raschzok
Johann Pratschke
Dennis Eurich
Luca Dittrich
Eva Maria Dobrindt
author_sort Ramin Raul Ossami Saidy
collection DOAJ
description Introduction: The development of chronic kidney disease (CKD) is a common and significant complication, contributing to morbidity after liver transplantation (LT). Cytomegalovirus (CMV) infection is common in the overall population, and relevant reinfection after LT may occur. CMV-associated kidney damage has been discussed, but the clinical significance on CKD development after LT remains unclear. Methods: A total of 745 patients who underwent LT between 2006 and 2017 were included in this retrospective analysis. Clinical data, as well as laboratory parameters, were analyzed. Univariate and multivariate analysis were performed. Results: The univariate analysis revealed significantly impaired estimated glomerular filtration rates (eGFRs) in patients with histories of CMV infection (81.4 (8–137) mL/min vs. 90.0 (5–147) mL/min; <i>p</i> = 0.004). This effect was confirmed in the multivariate analysis. Post-LT, eGFR was impaired in patients with CMV (re)infection at 6, 12, 36, and 60 months, 10 years, and 15 years after LT. Immunosuppressive levels were comparable between groups. Overall survival was negatively affected by CMV infection (<i>p</i> = 0.001). Discussion: A clinically significant detrimental impact of CMV infection on renal function was observed, that could individualize clinical risk evaluation prior and after LT further. However, the pathophysiological mechanisms behind this observation are not yet understood.
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spelling doaj-art-16a1a4df9a3b40388bc28d6e91f3ad3a2024-12-27T14:58:58ZengMDPI AGViruses1999-49152024-11-011612183010.3390/v16121830The Association Between Cytomegalovirus Infection and Kidney Damage in the Liver Transplant SettingRamin Raul Ossami Saidy0Franziska Eurich1Brigitta Globke2Wenzel Schöning3Robert Öllinger4Nathanael Raschzok5Johann Pratschke6Dennis Eurich7Luca Dittrich8Eva Maria Dobrindt9Department of Surgery, Campus Virchow Klinikum and Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Surgery, Campus Virchow Klinikum and Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Surgery, Campus Virchow Klinikum and Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Surgery, Campus Virchow Klinikum and Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Surgery, Campus Virchow Klinikum and Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Surgery, Campus Virchow Klinikum and Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Surgery, Campus Virchow Klinikum and Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Surgery, Campus Virchow Klinikum and Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Surgery, Campus Virchow Klinikum and Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Surgery, Campus Virchow Klinikum and Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyIntroduction: The development of chronic kidney disease (CKD) is a common and significant complication, contributing to morbidity after liver transplantation (LT). Cytomegalovirus (CMV) infection is common in the overall population, and relevant reinfection after LT may occur. CMV-associated kidney damage has been discussed, but the clinical significance on CKD development after LT remains unclear. Methods: A total of 745 patients who underwent LT between 2006 and 2017 were included in this retrospective analysis. Clinical data, as well as laboratory parameters, were analyzed. Univariate and multivariate analysis were performed. Results: The univariate analysis revealed significantly impaired estimated glomerular filtration rates (eGFRs) in patients with histories of CMV infection (81.4 (8–137) mL/min vs. 90.0 (5–147) mL/min; <i>p</i> = 0.004). This effect was confirmed in the multivariate analysis. Post-LT, eGFR was impaired in patients with CMV (re)infection at 6, 12, 36, and 60 months, 10 years, and 15 years after LT. Immunosuppressive levels were comparable between groups. Overall survival was negatively affected by CMV infection (<i>p</i> = 0.001). Discussion: A clinically significant detrimental impact of CMV infection on renal function was observed, that could individualize clinical risk evaluation prior and after LT further. However, the pathophysiological mechanisms behind this observation are not yet understood.https://www.mdpi.com/1999-4915/16/12/1830liver transplantationcytomegaloviruschronic kidney diseaseimmunosuppression
spellingShingle Ramin Raul Ossami Saidy
Franziska Eurich
Brigitta Globke
Wenzel Schöning
Robert Öllinger
Nathanael Raschzok
Johann Pratschke
Dennis Eurich
Luca Dittrich
Eva Maria Dobrindt
The Association Between Cytomegalovirus Infection and Kidney Damage in the Liver Transplant Setting
Viruses
liver transplantation
cytomegalovirus
chronic kidney disease
immunosuppression
title The Association Between Cytomegalovirus Infection and Kidney Damage in the Liver Transplant Setting
title_full The Association Between Cytomegalovirus Infection and Kidney Damage in the Liver Transplant Setting
title_fullStr The Association Between Cytomegalovirus Infection and Kidney Damage in the Liver Transplant Setting
title_full_unstemmed The Association Between Cytomegalovirus Infection and Kidney Damage in the Liver Transplant Setting
title_short The Association Between Cytomegalovirus Infection and Kidney Damage in the Liver Transplant Setting
title_sort association between cytomegalovirus infection and kidney damage in the liver transplant setting
topic liver transplantation
cytomegalovirus
chronic kidney disease
immunosuppression
url https://www.mdpi.com/1999-4915/16/12/1830
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