Cytomegalovirus Disease After Kidney Transplantation: Clues to Accurate Diagnosis

Abstract

Background The clinical diagnosis of cytomegalovirus (CMV) disease after kidney transplantation is often not accurate. We evaluated the factors associated with a correct diagnosis of CMV disease in these patients. Materials and Methods This retrospective study of all renal transplant patients between 2004 and 2005 with a clinical diagnosis of CMV disease included both donors and recipients who were seropositive for CMV at transplantation. We assessed the rate and correlated factors with a correct diagnosis. Results Among 127 cases, the 30 (23.6%) patients who had a correct diagnosis of CMV disease. Showed higher ages at transplantation (48.8 ± 15.3 vs. 39.8 ± 14.4 years; P = .004) and a shorter interval between transplantation and symptom presentation (9.7 ± 20.7 vs. 25.6 ± 33.6 days; P = .048). Diabetes mellitus (DM) was the cause of end-stage renal disease (ESRD) in 41% of patients with a correct diagnosis, whereas it was the cause in 11% of CMV disease-negative patients ( P < .001). A multiple logistic regression model showed that DM as the cause of ESRD ( P = .001; odds ratio [OR] 16.331), >5 months duration between transplantation and the presence of symptoms ( P = .001; OR, 0.060), and age at transplantation >55 years ( P = .022; OR, 3.833) were predictors of a correct diagnosis of CMV disease (χ 2 = 46.45; P < .001). Conclusion The results herein showed that considering some variables significantly improved the accuracy of a correct diagnosis of CMV disease after kidney transplantation.