Nemati E, Eizadi M, Lankarani M Moghani, Kardavani B, Khoddami-Vishteh H-R, Kalantar E, Lesan-Pezeshki M, Khedmat H, Saadat A R
Nephrology/Urology Research Center (NURC), Baqiyatallah Medical Sciences University, Tehran, Iran.
Transplant Proc. 2007 May;39(4):987-9. doi: 10.1016/j.transproceed.2007.03.087.
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.
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.
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).
The results herein showed that considering some variables significantly improved the accuracy of a correct diagnosis of CMV disease after kidney transplantation.
肾移植后巨细胞病毒（CMV）疾病的临床诊断往往不准确。我们评估了这些患者中与CMV疾病正确诊断相关的因素。
这项对2004年至2005年间所有临床诊断为CMV疾病的肾移植患者的回顾性研究，包括移植时CMV血清学阳性的供体和受体。我们评估了正确诊断的发生率及其相关因素。
在127例病例中，30例（23.6%）患者被正确诊断为CMV疾病。这些患者移植时年龄较大（48.8±15.3岁对39.8±14.4岁；P = 0.004），移植与症状出现之间的间隔较短（9.7±20.7天对25.6±33.6天；P = 0.048）。在正确诊断的患者中，41%的患者终末期肾病（ESRD）的病因是糖尿病（DM），而在CMV疾病阴性的患者中这一比例为11%（P<0.001）。多因素逻辑回归模型显示，ESRD病因是DM（P = 0.001；比值比[OR]16.331）、移植与症状出现之间的持续时间>5个月（P = 0.001；OR，0.060）以及移植时年龄>55岁（P = 0.022；OR，3.833）是CMV疾病正确诊断的预测因素（χ2=46.45；P<0.001）。
本文结果表明，考虑一些变量可显著提高肾移植后CMV疾病正确诊断的准确性。
