Hemorrhagic cystitis due to adenovirus in kidney transplantation: Epidemiological review and clinical results
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Keywords

adenovirus
kidney transplantation
urinary tract infections
cystitis
chronic kidney disease
hematuria

How to Cite

1.
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

Abstract

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.

https://doi.org/10.22265/acnef.9.2.579
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