Chikungunya on Kidney Transplant Recipients: Is It the Same?

BACKGROUNDChikungunya virus (CHIKV) infection is an acute febrile illness with polyarthralgia and arthritis. There are few data about CHIKV infection in kidney transplant recipients (KTR). We report the largest case series of CHIKV infection in this population. METHODSWe retrospectively analyzed 32...

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Bibliographic Details
Published in:	Transplantation Vol. 103; no. 2; pp. 441 - 445
Main Authors:	Tavares, Bruno M, Fernandes, Paula FCBC, Oliveira, Cláudia Maria C, Silva, Sônia L, Mota, Márcia U, Andrade, Tacilla HS, Cunha, Samuel F, Girão, Evelyne S
Format:	Journal Article
Language:	English
Published:	United States Copyright Wolters Kluwer Health, Inc. All rights reserved 01-02-2019
Subjects:	Acute Kidney Injury - etiology Adult Aged Arthralgia - etiology Chikungunya Fever - complications Female Humans Kidney Transplantation - adverse effects Male Middle Aged Retrospective Studies
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Summary:	BACKGROUNDChikungunya virus (CHIKV) infection is an acute febrile illness with polyarthralgia and arthritis. There are few data about CHIKV infection in kidney transplant recipients (KTR). We report the largest case series of CHIKV infection in this population. METHODSWe retrospectively analyzed 32 cases of CHIKV infection in KTR between January 2016 and December 2017 at Hospital Universitário Walter Cantídio of Federal University of Ceará. RESULTSAll patients had been in endemic areas before the beginning of the symptoms. All presented arthralgia, 15 (46.9%) with joint inflammatory symptoms and 14 (43.8%) evolved to chronic arthralgia. Seven (21.9%) showed acute kidney injury (AKI) by Kidney DiseaseImproving Global Outcomes criteria during the acute phase. Acute kidney injury was not related to prednisone use (odds ratio [OR], 0.3; 95% confidence interval [CI], 0.04-2.61, P = 0.3) nor chronic arthralgia (OR, 1.2; 95% CI, 0.2-8.4, P = 0.8) as well as male sex, chronic kidney disease and older than 60 years (OR, 1.7; 95% CI, 0.3-10.3, P = 0.58; OR, 0.4; 95% CI, 0.1-2.7, P = 0.4; and OR, 2.1; 95% CI, 0.3-14.9, P = 0.45, respectively). Hospitalization was associated to AKI (OR, 44.0; 95% CI, 3.8-503.1; P = 0.002), probably due to diarrhea or dehydration. One patient died throughout the study, possibly unassociated with CHIKV infection. CONCLUSIONSKTR with CHIKV infection have a clinical presentation and evolution similar to those seen in the general population. Kidney function is generally well preserved, with transitory graft dysfunction without negative impact after 3 months from the beginning of the symptoms. Previous costicosteroids use did not relate with AKI or chronic arthralgia.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0041-1337 1534-6080
DOI:	10.1097/TP.0000000000002363