Hemorrhagic cystitis due to adenovirus in kidney transplantation: Epidemiological review and clinical results
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kidney transplantation
urinary tract infections
chronic kidney disease

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Acuña CF, Valderrama LA, Mejía AF, Paredes-Fernández A, Ramírez M. Hemorrhagic cystitis due to adenovirus in kidney transplantation: Epidemiological review and clinical results. Rev. Colomb. Nefrol. [Internet]. 2022 Sep. 24 [cited 2024 Jul. 16];9(2). Available from: https://revistanefrologia.org/index.php/rcn/article/view/579


Introduction: Urinary tract infection (UTI) caused by adenovirus (ADV) after kidney transplantation has the potential to cause graft dysfunction or loss. The clinical presentation is variable, from an asymptomatic course to a multisystemic compromise. Treatment varies based on the availability of different medications and clinical experience.

Objective: The study describe the clinical, laboratory characteristics and results of a series of cases of kidney transplant patients with hemorrhagic cystitis secondary to ADV infection in a hospital in Cali, Colombia.

Methods: Retrospective study based on the records of patients with a diagnosis of UTI caused by ADV between January 2015 to January 2021 were included. The diagnosis was made by clinical suspicion and polymerase chain reaction (PCR) - Adenovirus DNA viral load.

Results: Of 256 transplant patients, eight patients had a diagnosis of hemorrhagic cystitis or interstitial nephritis secondary to ADV infection. It presented early (? 3 months) in 62%, who presented with macrohematuria, associated with sterile pyuria and lymphopenia. Alterations in renal function were presented in 87.5%. The reduction of immunosuppression was the fundamental pillar in the management.

Conclusions: The recognition of ADV infection in kidney transplant patients has been increasing. Clinical suspicion is the key for the diagnosis, with a predominance of macrohematuria, irritative urinary symptoms and kidney graft dysfunction. Reducing the dose of immunosuppression by restoring immune function may be sufficient in resolving the infection and reversing renal dysfunction.

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