{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:46:43Z","timestamp":1793832403836,"version":"4.6.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2019,10,15]],"date-time":"2019-10-15T00:00:00Z","timestamp":1571097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"National Institute for Health Research Academic Clinical Fellowship"},{"name":"National Health Service"},{"DOI":"10.13039\/501100000276","name":"UK Department of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cardiovascular disease (CVD) is the leading cause of early death in patients with chronic kidney disease (CKD). Previous work has described an association between Cytomegalovirus (CMV) seropositivity and CVD amongst patients with dialysis dependent end stage renal disease. Whether CMV seropositivity is associated with CVD in non-dialysis dependent CKD has not been established.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>Investigate whether past CMV infection is associated with prevalent CVD in patients with non-dialysis dependent CKD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>A retrospective observational study using the Renal Impairment in Secondary Care cohort, a study evaluating bio-clinical determinants of outcomes in patients with progressive CKD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We assayed cryopreserved serum samples collected at inception for anti-CMV IgG antibodies from 764 patients with stages 2 to 5 CKD (pre-dialysis) and investigated its relationship with prevalent CVD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Median estimated glomerular filtration was 24\u2009ml\/min\/1.73 m2 (IQR 19\u201332). Sixty-eight percent of patients were CMV seropositive. CMV seropositivity was associated with older age, non-Caucasian ethnicity, diabetes and higher social deprivation index score. On univariable analysis, CMV seropositivity correlated with higher systolic blood pressure (P\u2009=\u20090.044), prevalent CVD (P\u2009&amp;lt;\u20090.001), ischaemic heart disease (P\u2009&amp;lt;\u20090.001) and cerebrovascular disease (P\u2009=\u20090.022). On multivariable analysis, CMV seropositive patients nearly twice as likely to have CVD compared to seronegative patients [Odds Ratio (OR)\u2009=\u20091.998, CI 1.231\u20133.242, P\u2009=\u20090.005].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In patients with non-dialysis CKD, CMV seropositivity is independently associated with a higher prevalence of CVD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/qjmed\/hcz258","type":"journal-article","created":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T11:40:09Z","timestamp":1571053209000},"page":"253-257","source":"Crossref","is-referenced-by-count":7,"title":["Cytomegalovirus seropositivity is independently associated with cardiovascular disease in non-dialysis dependent chronic kidney disease"],"prefix":"10.1093","volume":"113","author":[{"given":"A H K","family":"Karangizi","sequence":"first","affiliation":[{"name":"Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK"},{"name":"Renal Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Chanouzas","sequence":"first","affiliation":[{"name":"Renal Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK"},{"name":"Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Fenton","sequence":"first","affiliation":[{"name":"Renal Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Moss","sequence":"first","affiliation":[{"name":"Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Cockwell","sequence":"first","affiliation":[{"name":"Renal Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C J","family":"Ferro","sequence":"first","affiliation":[{"name":"Renal Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Harper","sequence":"first","affiliation":[{"name":"Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK"},{"name":"Renal Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,10,15]]},"reference":[{"key":"2020040609453782400_hcz258-B1","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1016\/S0140-6736(10)60674-5","article-title":"Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis","volume":"375","author":"Matsushita","year":"2010","journal-title":"Lancet"},{"key":"2020040609453782400_hcz258-B2","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1038\/ki.2010.531","article-title":"Lower estimated GFR and higher albuminuria are associated with adverse kidney outcomes. A collaborative meta-analysis of general and high-risk population cohorts","volume":"80","author":"Gansevoort","year":"2011","journal-title":"Kidney Int"},{"key":"2020040609453782400_hcz258-B3","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1038\/ki.2010.536","article-title":"Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts","volume":"79","author":"van der Velde","year":"2011","journal-title":"Kidney Int"},{"key":"2020040609453782400_hcz258-B4","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1056\/NEJMoa041031","article-title":"Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization","volume":"351","author":"Go","year":"2004","journal-title":"N Engl J Med"},{"key":"2020040609453782400_hcz258-B5","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/S0140-6736(13)60595-4","article-title":"Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention","volume":"382","author":"Gansevoort","year":"2013","journal-title":"Lancet"},{"key":"2020040609453782400_hcz258-B6","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1002\/rmv.655","article-title":"Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection","volume":"20","author":"Cannon","year":"2010","journal-title":"Rev Med Virol"},{"key":"2020040609453782400_hcz258-B7","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/acel.12430","article-title":"CMV seropositivity and T-cell senescence predict increased cardiovascular mortality in octogenarians: results from the Newcastle 85+ study","volume":"15","author":"Spyrudioiulos","year":"2016","journal-title":"Aging Cell"},{"key":"2020040609453782400_hcz258-B8","doi-asserted-by":"crossref","first-page":"6537","DOI":"10.1007\/s11033-012-1482-6","article-title":"Cytomegalovirus infection and coronary heart disease risk: a meta-analysis","volume":"39","author":"Ji","year":"2012","journal-title":"Mol Biol Rep"},{"key":"2020040609453782400_hcz258-B9","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1007\/s11239-011-0662-x","article-title":"Human cytomegalovirus infection and atherothrombosis","volume":"33","author":"Popovic","year":"2012","journal-title":"J Thrombosis Thrombolysis"},{"key":"2020040609453782400_hcz258-B10","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.116.005025","article-title":"Cytomegalovirus infection and relative risk of cardiovascular disease (Ischaemic heart disease, stroke and cardiovascular death): a meta-analysis of prospective studies up to 2016","volume":"6","author":"Wang","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"2020040609453782400_hcz258-B11","doi-asserted-by":"crossref","first-page":"3298","DOI":"10.1093\/ndt\/gfm348","article-title":"Seropositivity for cytomegalovirus in patients with end-stage renal disease is strongly associated with atherosclerotic disease","volume":"22","author":"Betjes","year":"2007","journal-title":"Nephrol Dial Transplant"},{"key":"2020040609453782400_hcz258-B12","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1081\/JDI-120039527","article-title":"Infectious risk factors for atherosclerotic vascular disease in hemodialysis patients\u2013Chlamydia pneumoniae but not Helicobacter pylori or cytomegalovirus is associated with increased C-reactive protein","volume":"26","author":"Wolf","year":"2004","journal-title":"Ren Fail"},{"key":"2020040609453782400_hcz258-B13","doi-asserted-by":"crossref","first-page":"95.","DOI":"10.1186\/1471-2369-14-95","article-title":"The natural history of, and risk factors for, progressive chronic kidney disease (CKD): the Renal Impairment in Secondary care (RIISC) study; rationale and protocol","volume":"14","author":"Stringer","year":"2013","journal-title":"BMC Nephrol"},{"key":"2020040609453782400_hcz258-B14"},{"key":"2020040609453782400_hcz258-B15","first-page":"218","article-title":"Optimising the accuracy of blood pressure monitoring in chronic kidney disease: the utility of BpTRU in kidney disease","volume":"14","author":"Brothwell","year":"2011","journal-title":"Am Soc Nephrol"},{"key":"2020040609453782400_hcz258-B16","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1016\/j.healun.2015.03.015","article-title":"Influence of cytomegalovirus infection in the development of cardiac allograft vasculopathy after heart transplantation","volume":"34","author":"Delgado","year":"2015","journal-title":"J Heart Lung Transplant"},{"key":"2020040609453782400_hcz258-B17","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1097\/TP.0000000000000522","article-title":"Reduced rate of cardiovascular death after cytomegalovirus prophylaxis in renal transplant recipients","volume":"99","author":"Opelz","year":"2015","journal-title":"Transplantation"},{"key":"2020040609453782400_hcz258-B18","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1093\/qjmed\/hcw026","article-title":"Cytomegalovirus infection is associated with an increase in systolic blood pressure in older individuals","volume":"109","author":"Firth","year":"2016","journal-title":"QJM"},{"key":"2020040609453782400_hcz258-B19","doi-asserted-by":"crossref","first-page":"e55686.","DOI":"10.1371\/journal.pone.0055686","article-title":"Cytomegalovirus seropositivity is associated with increased arterial stiffness in patients with chronic kidney disease","volume":"8","author":"Wall","year":"2013","journal-title":"PLoS One"},{"key":"2020040609453782400_hcz258-B20","doi-asserted-by":"crossref","first-page":"31.","DOI":"10.1186\/s12985-018-0937-3","article-title":"Human cytomegalovirus infection and coronary heart disease: a systematic review","volume":"15","author":"Du","year":"2018","journal-title":"Virol J"},{"key":"2020040609453782400_hcz258-B21","doi-asserted-by":"crossref","first-page":"194.","DOI":"10.1186\/s13075-018-1695-8","article-title":"The host cellular immune response to cytomegalovirus targets the endothelium and is associated with increased arterial stiffness in ANCA-associated vasculitis","volume":"20","author":"Chanouzas","year":"2018","journal-title":"Arthritis Res Ther"},{"key":"2020040609453782400_hcz258-B22","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1093\/infdis\/jiy493","article-title":"Subclinical reactivation of cytomegalovirus drives CD4+CD28null T-cell expansion and impaired immune response to pneumococcal vaccination in antineutrophil cytoplasmic antibody\u2013associated vasculitis","volume":"219","author":"Chanouzas","year":"2019","journal-title":"J Infect Dis"},{"key":"2020040609453782400_hcz258-B23","doi-asserted-by":"crossref","first-page":"e06068","DOI":"10.7554\/eLife.06068","article-title":"Release of human cytomegalovirus from latency by a KAP1\/TRIM28 phosphorylation switch","volume":"4","author":"Rauwel","year":"2015","journal-title":"Elife"},{"key":"2020040609453782400_hcz258-B24","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1016\/S0735-1097(99)00410-6","article-title":"Cytomegalovirus in the pathogenesis of atherosclerosis: the role of inflammation as reflected by elevated C-reactive protein levels","volume":"34","author":"Zhu","year":"1999","journal-title":"J Am Coll Cardiol"},{"key":"2020040609453782400_hcz258-B25","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.1161\/01.CIR.102.16.1917","article-title":"Cytomegalovirus seropositivity and C-reactive protein have independent and combined predictive value for mortality in patients with angiographically demonstrated coronary artery disease","volume":"102","author":"Muhlestein","year":"2000","journal-title":"Circulation"},{"key":"2020040609453782400_hcz258-B26","doi-asserted-by":"crossref","first-page":"e16103.","DOI":"10.1371\/journal.pone.0016103","article-title":"Seropositivity to cytomegalovirus, inflammation, all-cause and cardiovascular disease-related mortality in the United States","volume":"6","author":"Simanek","year":"2011","journal-title":"PLoS One"}],"container-title":["QJM: An International Journal of Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/qjmed\/advance-article-pdf\/doi\/10.1093\/qjmed\/hcz258\/30989985\/hcz258.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/qjmed\/article-pdf\/113\/4\/253\/33015666\/hcz258.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/qjmed\/article-pdf\/113\/4\/253\/33015666\/hcz258.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,6]],"date-time":"2020-04-06T13:46:07Z","timestamp":1586180767000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/qjmed\/article\/113\/4\/253\/5587767"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,15]]},"references-count":26,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,10,15]]},"published-print":{"date-parts":[[2020,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/qjmed\/hcz258","relation":{},"ISSN":["1460-2725","1460-2393"],"issn-type":[{"value":"1460-2725","type":"print"},{"value":"1460-2393","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,4]]},"published":{"date-parts":[[2019,10,15]]}}}