Cytomegalovirus Status of Kidney Transplant Recipients and Cardiovascular Risk

Background

Cytomegalovirus (CMV) infection is associated with an increased risk of cardiac complications in kidney transplant recipients (KTRs). Some data suggest that CMV may be involved in atherogenesis. The aim of the study was the analysis of CMV medical history in KTRs and its influence on cardiovascular (CV) incidents.

Materials and Methods

The study observed 254 patients (165 male/89 female) with mean age of 47.2 (range, 15–81) years and duration of dialysis before transplantation 29.2 months who received transplants in 1 university unit (2007–2013). Thirty-six patients were transplanted preemptively. The mean time of observation lasted 7 years. KTRs suffered from diabetes, hypertension, and hyperlipidemia (17.3%, 88.5%, and 61%, respectively). Coronary artery disease was diagnosed in 19.6% patients, 3.5% underwent elective coronary surgery operation, and 9.05% had CV incidents before transplantation. The following CMV donor/recipient (D/R) viral statuses were noticed in the study group: D+/R+ (68.9%), D+/R? (16.9%), D?/R+ (10.2%), and D?/B? (3.9%). D+/R? received universal CMV prophylaxis; the rest were under preemptive CMV prophylaxis. CMV infection affected 87 (34.25%) patients; there were 24 primary infections and 85 secondary infections (some patients had more than 1 CMV). Mean time of diagnosis of the primary and secondary CMV infection was 190.7 and 160.5 days, respectively.

Results

During observation 22 patients experienced 26 CV incidents: 15 were D+/R+, 6 were D+/R?, and 1 was D?/R+. CMV infections occurred in 40.9% of patients with CV incidents after kidney transplantation. In comparison, 33.6% patients without CV incidents after kidney transplantation suffered from CMV infection.

Conclusions

CMV infection in KTRs was not a crucial risk factor for CV incidents.