{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T16:24:41Z","timestamp":1648657481161},"reference-count":34,"publisher":"Portland Press Ltd.","issue":"18","content-domain":{"domain":["portlandpress.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,9,28]]},"abstract":"<jats:p>The indirect effects of cytomegalovirus (CMV) viremia can be related to chronic changes in renal allograft structure, but its real impact in early and late graft function remains speculative. A total of 159 patients undergoing renal transplantation using a preemptive therapeutic strategy to prevent CMV disease were included in the present study. The patients were prospectively followed, with serial measurements of urinary retinol-binding protein (uRBP), a marker of proximal tubule injury. uRBP levels and their dynamic performance were compared according to CMV viremia and the 5-year estimated glomerular filtration rate (eGFR), as measured with the modification of diet in renal disease (MDRD) equation. CMV viremia was detected in 79.9% of the patients, with high uRBP levels being detected in 76.0% of these patients (compared with 40.7% in CMV-, P=0.005). High uRBP was associated with male recipients (P=0.02), the number of mismatches (P=0.02) and CMV infection (P=0.001). Five-year eGFR was worse in patients with high uRBP levels (50.3 \u00b1 25.8 compared with 59.8 \u00b1 26.4 ml\/min, P=0.04). In a multivariate model, eGFR &amp;lt;60 ml\/min was associated with donor age (P&amp;lt;0.001), the number of mismatches (P=0.04), thymoglobulin dose (P=0.02), the presence of and time with delayed graft function (DGF) (P=0.005 and P=0.04), 1-month tacrolimus levels (P=0.03), and uRBP levels after CMV treatment (P=0.01). Patients with CMV viremia in whom uRBP levels were normalized up to 3 months after treatment showed significantly better 5-year eGFR than those in whom uRBP remained high: 61.0 \u00b1 24.2 compared with 42.3 \u00b1 23.9 ml\/min, P&amp;lt;0.001. CMV viremia was associated with high uRBP levels, which represent a profile of proximal tubule injury, and the dynamic performance of uRBP after treatment was associated with long-term kidney graft function.<\/jats:p>","DOI":"10.1042\/cs20180390","type":"journal-article","created":{"date-parts":[[2018,8,31]],"date-time":"2018-08-31T16:25:53Z","timestamp":1535732753000},"page":"2059-2069","update-policy":"http:\/\/dx.doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A high level of urinary retinol-binding protein is associated with cytomegalovirus infection in kidney transplantation"],"prefix":"10.1042","volume":"132","author":[{"given":"L\u00facio\u00a0R.","family":"Requi\u00e3o-Moura","sequence":"first","affiliation":[{"name":"Renal Transplantation Division, Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil"},{"name":"Department of Medicine, Nephrology Division, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana\u00a0C.C.","family":"Matos","sequence":"additional","affiliation":[{"name":"Renal Transplantation Division, Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kikumi\u00a0S.","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Renal Transplantation Division, Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niels\u00a0O.S.","family":"C\u00e2mara","sequence":"additional","affiliation":[{"name":"Department of Medicine, Nephrology Division, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"},{"name":"Department of Immunology, Institute of Biomedical Science, Universidade de S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvaro","family":"Pacheco-Silva","sequence":"additional","affiliation":[{"name":"Renal Transplantation Division, Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil"},{"name":"Department of Medicine, Nephrology Division, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"288","published-online":{"date-parts":[[2018,9,19]]},"reference":[{"key":"2021113010584017800_B1","doi-asserted-by":"publisher","first-page":"1758","DOI":"10.1681\/ASN.2004121113","article-title":"Viral infection in the renal transplant recipient","volume":"16","author":"Kotton","year":"2005","journal-title":"J. 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