title: Hypocomplementemia in kidney transplant recipients: impact on the risk of infectious complications.
abstract: The usefulness of monitoring of complement levels in predicting the occurrence of infection in kidney transplant (KT) recipients remains largely unknown. We prospectively assessed serum complement levels (C3 and C4) at baseline and at months 1 and 6 in 270 patients undergoing KT. Adjusted hazard ratios (aHRs) for infection in each posttransplant period were estimated by Cox regression. The prevalence of C3 hypocomplementemia progressively decreased from 21.5% at baseline to 11.6% at month 6 (p = 0.017), whereas the prevalence of C4 hypocomplementemia rose from 3.7% at baseline to 9.2% at month 1 (p = 0.004). Patients with C3 hypocomplementemia at month 1 had higher incidences of overall (p = 0.002), bacterial (p = 0.004) and fungal infection (p = 0.019) in the intermediate period (months 1-6). On multivariate analysis C3 hypocomplementemia at month 1 emerged as a risk factor for overall (aHR 1.911; p = 0.009) and bacterial infection (aHR 2.130; p = 0.014) during the intermediate period, whereas C3 hypocomplementemia at month 6 predicted the occurrence of bacterial infection (aHR 3.347; p = 0.039) in the late period (>6 month). A simple monitoring strategy of serum C3 levels predicts the risk of posttransplant infectious complications in KT recipients.
authors: Unit of Infectious Diseases, Instituto de Investigación Hospital 12 de Octubre (i+12), Hospital Universitario 12 de Octubre, 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: J M
authors: JM
authors: Morales
authors: A
authors: A
authors: García-Reyne
authors: R
authors: R
authors: San Juan
authors: C
authors: C
authors: Lumbreras
authors: D
authors: D
authors: Lora-Pablos
authors: N
authors: N
authors: Polanco
authors: A
authors: A
authors: Andrés
authors: E
authors: E
authors: Paz-Artal
authors: J M
authors: JM
authors: Aguado
mesh_terms: D003176:Complement C3 / Q000172:deficiency*; D005260:Female; D006084:Graft Rejection / Q000209:etiology* / Q000401:mortality; D006085:Graft Survival; D006801:Humans; D007239:Infections / Q000209:etiology* / Q000401:mortality; D007674:Kidney Diseases / Q000150:complications* / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D062606:Tertiary Care Centers
chemical_list: D003176:Complement C3