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Cytomegalovirus infection in patients with glomerular diseases treated with cyclophosphamide: a single-center prospective study

  • Nephrology - Original Paper
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Abstract

Purpose

Cytomegalovirus infection is an important complication in immunocompromised patients. As few studies have shown that cyclophosphamide treatment is a risk factor for cytomegalovirus infection in patients with glomerulonephritis, we aimed to describe the frequency and risk factors of cytomegalovirus infection in glomerulonephritis patients treated with cyclophosphamide.

Methods

We prospectively recruited 43 cytomegalovirus seropositive patients with glomerulonephritis treated with cyclophosphamide. We screened all patients for viral DNA monthly during treatment. Patients were compared for age, sex, glomerular pathology, renal function and clinical status regarding development of cytomegalovirus infection before and after the treatment.

Results

Cytomegalovirus infection was detected in 10 (23.3%) patients, most commonly within the first 2 months of cyclophosphamide treatment. All patients recovered without any cytomegalovirus-related complications. Patients with cytomegalovirus infection had higher serum creatinine (4.2 ± 3.2 vs. 1.9 ± 1.8 mg/dl, p = 0.006) and lower estimated glomerular filtration rate (29 ± 11 vs. 65 ± 8 ml/min/1.73 m2, p = 0.016) at diagnosis compared with cytomegalovirus infection non-occurred patients. In addition, number of patients presented with rapidly progressive glomerulonephritis were higher in cytomegalovirus infection group (80.0% vs. 27.3%, p = 0.007). Moreover, cytomegalovirus infection was associated with prolonged hospital stay (54 ± 7 vs. 29 ± 6 days, p = 0.027).

Conclusion

Cytomegalovirus infection is a common complication in glomerulonephritis patients treated with cyclophosphamide in this prospective study. Routine monitoring and prophylaxis should be considered for these high-risk patients.

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Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

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Funding

None of the authors received any financial interest, direct or indirect, related to the achievement of this work.

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Author notes

  1. Gizem Kumru Sahin

    Present address: Department of Nephrology, Ministry of Health Van Education Research Hospital, Van, Turkey

Authors and Affiliations

  1. Department of Nephrology, Ankara University School of Medicine, Ankara, Turkey

    Gizem Kumru Sahin, Sahin Eyupoglu, Rezzan Eren Sadioglu, Kenan Ates, Sehsuvar Erturk, Gokhan Nergizoglu, Sule Sengul, Sim Kutlay & Kenan Keven

  2. Department of Infectious Disease and Clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey

    Gule Cinar

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  1. Gizem Kumru Sahin
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  2. Sahin Eyupoglu
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Contributions

All the authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [GKS], and [KK]. The first draft of the manuscript was written by [GKS], and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

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Correspondence to Gizem Kumru Sahin.

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The study protocol was approved by the ethical committee of Ankara University and was conducted in accordance with the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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Kumru Sahin, G., Eyupoglu, S., Eren Sadioglu, R. et al. Cytomegalovirus infection in patients with glomerular diseases treated with cyclophosphamide: a single-center prospective study. Int Urol Nephrol 54, 1091–1096 (2022). https://doi.org/10.1007/s11255-021-02973-w

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  • DOI: https://doi.org/10.1007/s11255-021-02973-w

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