Cytomegalovirus disease after kidney transplantation: Clues to accurate diagnosis
Background. The clinical diagnosis of cytornegalovirus (CMV) disease after kidney transplantation is often not accurate. We evaluated the factors associated with a correct diagnosis of CMV disease in these patients. Materials and Methods. 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. Results. 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 (x(2) = 46.45; P < .001). Conclusion. The results herein showed that considering some variables significantly improved the accuracy of a correct diagnosis of CMV disease after kidney transplantation.