Longitudinal real-time PCR monitoring of CMV DNAemia and renal function in living-donor kidney transplant recipients with low immunological risk.

OBJECTIVE

This study evaluated the association between CMV DNAemia and renal function during the first 12 months after living-donor kidney transplantation in recipients with low immunological risk and explored differences in CMV DNAemia according to preemptive kidney transplantation status.

MATERIALS AND

METHODS

A total of 112 living-donor kidney transplant recipients (mean age, 37.07 ± 14.41 years) were followed for 12 months. CMV DNAemia was monitored using quantitative real-time PCR targeting the UL55 (gB) gene. Longitudinal changes were analysed using Friedman and repeated-measures ANOVA, with the Mann -Whitney U test for between-group creatinine comparisons and the independent-samples t-test for GFR (p < 0.05).

RESULTS

CMV DNAemia was detected in 25.9% of recipients. Among recipients with CMV DNAemia, serum creatinine differed significantly across the four time points (p = 0.004), whereas GFR showed no significant change over time (p = 0.278). At 6 months, serum creatinine was significantly higher in recipients with CMV DNAemia than in those with no DNAemia (1.38 (1.05-1.70) vs. 1.17 (0.93-1.40) mg/dL; p = 0.047), while the between-group difference in GFR did not reach statistical significance (p = 0.054). Recipients who underwent preemptive kidney transplantation had numerically lower CMV DNA levels at month 6 (491 vs. 1206 IU/mL) than those with a history of dialysis. Urine protein-to-creatinine ratio (UPCR) decreased significantly during follow-up (p < 0.001), while WBC (p = 0.004) and CRP (p = 0.014) changed significantly over time.

CONCLUSION

In unadjusted analyses, recipients with CMV DNAemia had significantly higher serum creatinine levels at 6 months compared with those with no DNAemia, while the corresponding difference in GFR was not statistically significant. Differences according to preemptive kidney transplantation status were descriptive and should not be interpreted as evidence of a protective effect. Because of the observational design of the study, these findings should be interpreted with caution and confirmed in prospective studies.