title: Monitoring of immunoglobulin levels identifies kidney transplant recipients at high risk of infection.
abstract: We aimed to analyze the incidence, risk factors and impact of hypogammaglobulinemia (HGG) in 226 kidney transplant (KT) recipients in which serum immunoglobulin (Ig) levels were prospectively assessed at baseline, month 1 (T(1) ), and month 6 (T(6) ). The prevalence of IgG HGG increased from 6.6% (baseline) to 52.0% (T(1) ) and subsequently decreased to 31.4% (T(6) ) (p < 0.001). The presence of IgG HGG at baseline (odds ratio [OR] 26.9; p = 0.012) and a positive anti-HCV status (OR 0.17; p = 0.023) emerged as risk factors for the occurrence of posttransplant IgG HGG. Patients with HGG of any class at T(1) had higher incidences of overall (p = 0.018) and bacterial infection (p = 0.004), bacteremia (p = 0.054) and acute pyelonephritis (p = 0.003) in the intermediate period (months 1-6). Patients with HGG at T(6) had higher incidences of overall (p = 0.004) and bacterial infection (p < 0.001) in the late period (>6 month). A complementary log-log model identified posttransplant HGG as an independent risk factor for overall (hazard ratio [HR] 2.03; p < 0.001) and bacterial infection (HR 2.68; p < 0.0001). Monitoring of humoral immunity identifies KT recipients at high risk of infection, offering the opportunity for preemptive immunoglobulin replacement therapy.
authors: Unit of Infectious Diseases, Hospital Universitario 12 de Octubre. Instituto de Investigación Hospital 12 de Octubre (i+12), School of Medicine, Universidad Complutense, Madrid, Spain. mario_fdezruiz@yahoo.es
authors: M
authors: M
authors: Fernández-Ruiz
authors: F
authors: F
authors: López-Medrano
authors: P
authors: P
authors: Varela-Peña
authors: D
authors: D
authors: Lora-Pablos
authors: A
authors: A
authors: García-Reyne
authors: E
authors: E
authors: González
authors: J M
authors: JM
authors: Morales
authors: R
authors: R
authors: San Juan
authors: C
authors: C
authors: Lumbreras
authors: E
authors: E
authors: Paz-Artal
authors: A
authors: A
authors: Andrés
authors: J M
authors: JM
authors: Aguado
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood*; D007239:Infections / Q000209:etiology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D007136:Immunoglobulins