title: Serologic evidence of Chlamydia pneumoniae infection as a long-term predictor of cardiovascular death in renal transplant recipients.
abstract: BACKGROUND
  Cardiovascular disease is the main cause of death with a functioning graft in renal transplant recipients. Elevated levels of C-reactive protein (CRP) and evidence of chronic Chlamydia pneumoniae infection have been linked to cardiovascular disease and survival in patients with normal renal function and patients with end-stage renal disease on dialysis. So far, no such data have been available in renal transplant recipients.
  
  
  METHODS
  CRP, immunoglobulin (Ig)G and IgA antibodies to C. pneumoniae, and classic risk factors were compiled in 143 patients who underwent renal transplantation between January 1989 and April 1991. Samples were collected at transplantation, 1 year later, and at study end. Cardiovascular disease, death, and graft loss were documented during follow-up.
  
  
  RESULTS
  A total of 44 patients died during a mean follow-up of 10 years. Cardiac events were responsible for 37% of deaths. Age, gender, number of antihypertensive drugs, and seropositivity for IgG and IgA antibodies to C. pneumoniae, but not CRP levels, were significantly associated with cardiac death. C. pneumoniae serology and CRP levels, however, did not influence graft survival. Age, presence of diabetes, calcium phosphorus ion product, number of antihypertensive drugs, serum creatinine at 1 year, and presence of chronic rejection were all negatively correlated with graft survival.
  
  
  CONCLUSIONS
  Serologic evidence of chronic C. pneumoniae infection is associated with mortality as the result of cardiovascular disease in renal transplant recipients. CRP serum levels do not predict cardiac death in renal transplant recipients, in contrast with patients with normal renal function and patients on dialysis.
authors.affiliation: Department of Nephrology, Hannover Medical School, Carl-Neuberg-Strasse-1, 30625 Hannover, Germany. Haubitz.Marion@MH-Hannover.de
authors.forename: Marion
authors.initials: M
authors.lastname: Haubitz
authors.forename: Katrin
authors.initials: K
authors.lastname: Votsch
authors.forename: Alexander
authors.initials: A
authors.lastname: Woywodt
authors.forename: Björn
authors.initials: B
authors.lastname: Nashan
authors.forename: Annemarie
authors.initials: A
authors.lastname: Groh
authors.forename: Herrmann
authors.initials: H
authors.lastname: Haller
authors.forename: Reinhard
authors.initials: R
authors.lastname: Brunkhorst
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000401:mortality*; D023521:Chlamydophila Infections / Q000175:diagnosis*; D016993:Chlamydophila pneumoniae; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis*; D011379:Prognosis; D012698:Serologic Tests
chemical_list: D002097:C-Reactive Protein