Exploring Cytomegalovirus Infection in Renal Transplant Recipients: A Comprehensive Literature Review

Abstract

Background: Complication in kidneys the cytomegalovirus (CMV) infection still important in transplantation, due to un favoring effects on grafts survival and general patient result, the role in energizing acute or chronic allograft injury, good recognize but the CMV linked nephritis is regularly undiagnosed, emphasizing about of timely heading and its management.

Objective: The review aims to combine between current knowledge on CMV nephritis in the kidney transplant recipients emphasizing its fundamental mechanisms, diagnostic methods with therapeutic plans.

Methods: This literature review was conducted counting 15 peer-reviewed articles published in 2010 to 2022, databases searched are PubMed, Google Scholar, Cochrane Library, and Mendeley, with the keywords of “CMV kidney transplant” & “cytomegalovirus nephritis.” The data covered with patients’ clinical presentation, risk factors, histopathology, demographics and outcomes.

Results: The comprised studies were on transplant recipients aged rage between 38 to 62 years, representation of numerous ethnic groups and sexes showed with hypertension (HTN) and diabetes mellitus (DM) are common comorbidities, cases with multifaceted CMV-seronegative recipients with grafts due to seropositive donors. In the clinical look characteristically looked between 5 to12 weeks post-transplant having fever, fatigue, weakened graft function and raised  serum creatinine (S/Crt), in histological investigation showed tubulointerstitial nephritis with characteristic CMV insertions in tubular epithelial cells. Therapeutic management mainly be subject to Valganciclovir, with immunosuppressive therapy like mycophenolate mofetil or tacrolimus. In the clinical results mixed,  complete recovery 6 studies, partial recovery 5 studies, stable function 4 studies and graft lost 2 studies.  Conclusion: CMV nephritis had a stealth complication can threats graft survivals and the  management have a high index of doubt at-risk patients and histological confirmation. Accurate diagnosis is a essential to get the damaging effects of misdirected anti-rejection therapy like FK to reservation long-term graft function.