Kabat-Koperska Joanna, Kędzierska Karolina, Gołembiewska Edyta, Marchelek-Myśliwiec Małgorzata, Dutkiewicz Grażyna, Ciechanowski Kazimierz
Department of Nephrology and Transplantology, Pomeranian Medical University, Szczecin, Poland.
Ann Transplant. 2012 Apr-Jun;17(2):135-40.
To preserve kidney graft function it is necessary to use ganciclovir or valganciclovir as a therapy for fresh CMV infection or prophylaxis in high-risk kidney transplant recipients. Ganciclovir-induced lactic acidosis has thus far not been reported.
Three cases of nonrespiratory acidosis in kidney transplant recipients receiving ganciclovir or valganciclovir as anti-CMV therapy or prophylaxis are presented. Lactic acidosis developed in 2 patients, and the other patient had nonrespiratory acidosis of unknown origin. The possible mechanism of the development of lactic acidosis in presented cases is explored.
The analysis of the described cases cannot eliminate the potential negative influence of anti-CMV therapy on acid-base equilibrium, especially with coexisting active viral infection.
为了维持肾移植功能，对于高危肾移植受者，有必要使用更昔洛韦或缬更昔洛韦治疗新发巨细胞病毒（CMV）感染或进行预防。迄今为止，尚未有更昔洛韦诱发乳酸性酸中毒的报道。
本文介绍了3例接受更昔洛韦或缬更昔洛韦作为抗CMV治疗或预防的肾移植受者发生非呼吸性酸中毒的病例。2例患者发生了乳酸性酸中毒，另1例患者发生了病因不明的非呼吸性酸中毒。本文探讨了所报道病例中乳酸性酸中毒发生的可能机制。
对所描述病例的分析不能排除抗CMV治疗对酸碱平衡的潜在负面影响，尤其是在同时存在活动性病毒感染的情况下。
