Risk factors for Pneumocystis jiroveci pneumonia (PcP) in renal transplant recipients

Eitner, Frank; Hauser, Ingeborg A.; Rettkowski, O.; Rath, Thomas; Lopau, Kai; Pliquett, Rainer U.; Fiedler, Roman; Guba, Markus; Hilgers, Ralf-Dieter; Floege, Jürgen; Fischereder, Michael

doi:10.1093/ndt/gfq689

Cited by 65 publications

(104 citation statements)

References 21 publications

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“…(15) insufficiency were associated with high risks of opportunistic infection, especially P. jirovecii pneumonia. (17) Our study, which also focused on severe bacterial pneumonia in RTRs, showed that renal function was a significant short-term mortality determinant in such patients.…”

Section: Discussionmentioning

confidence: 71%

Immunosuppressant dose reduction and long-term rejection risk in renal transplant recipients with severe bacterial pneumonia

Shih¹,

Tarng²,

Wu³

et al. 2014

smedj

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Section: Discussionmentioning

confidence: 71%

Immunosuppressant dose reduction and long-term rejection risk in renal transplant recipients with severe bacterial pneumonia

Shih¹,

Tarng²,

Wu³

et al. 2014

smedj

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“…The PCP incidence in cancer patients without PCP prophylaxis varies by diagnosis (e.g., 22 to 45% for lymphomas and 25% for rhabdomyosarcomas) (125,264). Hematopoietic stem cell transplantation and solid organ transplantation also increases the risk of PCP, and these patients are generally offered PCP prophylaxis (72,75,106,325). Patients with collagen vascular disease have an elevated risk for PCP, particularly those with Wegener's granulomatosis (103,235).…”

Section: Recent Epidemiology Of Pcp In Non-hiv-infected Immunosuppresmentioning

confidence: 99%

Colonization by Pneumocystis jirovecii and Its Role in Disease

2012

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SUMMARY Although the incidence of Pneumocystis pneumonia (PCP) has decreased since the introduction of combination antiretroviral therapy, it remains an important cause of disease in both HIV-infected and non-HIV-infected immunosuppressed populations. The epidemiology of PCP has shifted over the course of the HIV epidemic both from changes in HIV and PCP treatment and prevention and from changes in critical care medicine. Although less common in non-HIV-infected immunosuppressed patients, PCP is now more frequently seen due to the increasing numbers of organ transplants and development of novel immunotherapies. New diagnostic and treatment modalities are under investigation. The immune response is critical in preventing this disease but also results in lung damage, and future work may offer potential areas for vaccine development or immunomodulatory therapy. Colonization with Pneumocystis is an area of increasing clinical and research interest and may be important in development of lung diseases such as chronic obstructive pulmonary disease. In this review, we discuss current clinical and research topics in the study of Pneumocystis and highlight areas for future research.

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“…The use of PCP chemoprophylaxis during CYC treatment is recommended by many experts (23,24) and should be considered with rituximab treatment as well. There are conflicting data about whether MMF may protect against or increase the risk of PCP in renal transplant recipients (25).…”

Section: Infectionsmentioning

confidence: 99%

Is Newer Safer? Adverse Events Associated with First-Line Therapies for ANCA-Associated Vasculitis and Lupus Nephritis

Hogan

Avasare

2014

Clinical Journal of the American Society of Nephrology

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Clinical outcomes in ANCA-associated vasculitis (AAV) and lupus nephritis have improved greatly with treatment regimens containing high-dose glucocorticoids and cyclophosphamide. However, with the use of these medications come significant adverse events, most notably infections, cytopenias, malignancies, and reproductive abnormalities. Multiple recent randomized controlled trials in AAV and lupus nephritis have compared cyclophosphamide-based regimens with agents such as rituximab, mycophenolate mofetil, and azathioprine, with the hope of providing better clinical outcomes with improved safety profiles. Although some of these newer regimens are now considered first-line treatments of these diseases, their adverse event profiles have been disappointingly similar to those of cyclophosphamide-based protocols. Physicians and patients should consider the adverse event profiles generated by these trials in the context of their extensive use in other patient populations, as well as available measures to prevent such events, when choosing the ideal regimen for an individual patient.

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Risk factors for Pneumocystis jiroveci pneumonia (PcP) in renal transplant recipients

Abstract: Our case-control study reveals a novel risk profile for PcP. Renal transplant recipients with more pronounced renal insufficiency following rejection episodes and treated with intensified immunosuppression are at particular risk for PcP.

Cited by 65 publications

References 21 publications

Immunosuppressant dose reduction and long-term rejection risk in renal transplant recipients with severe bacterial pneumonia

Immunosuppressant dose reduction and long-term rejection risk in renal transplant recipients with severe bacterial pneumonia

Colonization by Pneumocystis jirovecii and Its Role in Disease

Is Newer Safer? Adverse Events Associated with First-Line Therapies for ANCA-Associated Vasculitis and Lupus Nephritis

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