Cytomegalovirus disease after kidney transplantation: clues to accurate diagnosis.
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.


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 (chi(2)=46.45; P<.001).


CONCLUSIONS
The results herein showed that considering some variables significantly improved the accuracy of a correct diagnosis of CMV disease after kidney transplantation.
Nemati
E
E
Nephrology/Urology Research Center (NURC), Baqiyatallah Medical Sciences University, Tehran, Iran. eghlim.nemati@gmail.com
Eizadi
M
M
Lankarani
M Moghani
MM
Kardavani
B
B
Khoddami-Vishteh
H-R
HR
Kalantar
E
E
Lesan-Pezeshki
M
M
Khedmat
H
H
Saadat
A R
AR
D000328:Adult; D003430:Cross-Sectional Studies; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications / Q000821:virology*; D012044:Regression Analysis; D012189:Retrospective Studies