The pathologic spectrum of adenovirus nephritis in the kidney allograft

Jagannathan, Geetha; Weins, Astrid; Daniel, Emily; Crew, R. John; Swanson, S. John; Markowitz, Glen S.; D’Agati, Vivette D.; Andeen, Nicole K.; Rennke, Helmut G.; Batal, Ibrahim

doi:10.1016/j.kint.2022.10.025

Cited by 8 publications

(14 citation statements)

References 57 publications

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“…The results showed that the postoperative catheterization rate of patients who received refined nursing education was significantly lower than that of patients who received conventional nursing education, and the difference was statistically significant. Dysuria is one of the common complications after renal biopsy, and bed rest urination is an important factor in reducing dysuria [19,20]. Urination is a simple reflex activity.…”

Section: Discussionmentioning

confidence: 99%

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The effect of refined nursing education on improving the urination of patients after renal biopsy

Wang

Xie

et al. 2023

Ther Apher Dial

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BackgroundTo investigate the clinical effect of better nursing education on patients' postoperative urination after renal biopsy.MethodsIn this study, patients who underwent renal biopsy in the Department of Nephrology at our hospital were selected as the observation group (July–December 2018, n = 120) and control group (January–June 2018, n = 110) and received refined nursing education and routine nursing education, respectively. Postoperatively, the causes of dysuria after puncture, the degree of postoperative pain, and the urination mode were compared between the two groups.ResultsSix patients in the observation group and 23 patients in the control group needed urethral catheterization, accounting for about 5% and 15.2%, respectively. Therefore, the postoperative catheterization rate in the observation group was significantly lower than the control group, with a statistically significant difference.ConclusionThe refined nursing education proposed in this study can effectively improve urinary dysfunction after renal biopsy and has a clinical promotional value.

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Section: Discussionmentioning

confidence: 99%

“…Dysuria is one of the common complications after renal biopsy, and bed rest urination is an important factor in reducing dysuria [19, 20]. Urination is a simple reflex activity.…”

Section: Discussionmentioning

confidence: 99%

The effect of refined nursing education on improving the urination of patients after renal biopsy

Wang

Xie

et al. 2023

Ther Apher Dial

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“…All three cases in this series exhibited inflammatory responses similar to that reported in prior case reports and in a recent multi-institutional study. The three most common histologic patterns in AAIN include (1) granulomatous inflammation, (2) tubulocentric inflammation, and (3) acute tubular necrosis [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Apart from graft rejection, infections are important causes of early allograft dysfunction because of the immunosuppressed state of the host [ 1 ]. Infections of the renal allograft are commonly caused by polyomaviruses while adenoviruses have been identified as an uncommon cause of adenovirus allograft interstitial nephritis (AAIN) [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the urinary tract, adenoviruses typically cause hemorrhagic cystitis and can commonly affect the transitional epithelium of the ureters. In transplant recipients, adenovirus can affect the kidney parenchyma which can be difficult to diagnose on clinical grounds, but on kidney biopsy, there is characteristic tubulocentric granulomatous inflammation with visible viral cytopathic effect [ 1 ]. The diagnosis is typically confirmed with immunohistochemistry (IHC) against the group-specific hexon antigen which is meant to detect all clinically relevant adenoviral species and serotypes [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Adenovirus-Associated Acute Interstitial Nephritis With Graft Survival and Novel Follow-Up Biopsy Findings Including Karyomegaly: A Case Series

Lilley¹,

Borys²,

Picken³

2023

Cureus

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Adenoviral infections in post-transplant patients have been described in multiple organ systems, most classically the lung, liver, and alimentary tract. In the genitourinary tract, hemorrhagic cystitis is most frequently observed. Clinically apparent renal involvement with adenovirus is rare, and adenovirus-associated interstitial nephritis (AAIN) is an uncommon cause of renal allograft failure. Here, we present three cases of AAIN in patients who, after prompt diagnosis and treatment adjustment, experienced a return of allograft function. All patients were on standard triple therapy with tacrolimus levels within the target range at the time of biopsy. None of the patients had respiratory symptoms, and despite diarrhea, colon biopsies were negative. Only case one had positive adenovirus serology (IgG only) and case three had positive urine; two patients had leukopenia without neutropenia. Renal biopsies showed a characteristic granulomatous tubulocentric mixed lymphocytic and neutrophilic infiltrate. Adenovirus immunohistochemistry (IHC) showed strong staining in the tubular epithelium (nuclear and cytoplasmic) while staining for polyomavirus was negative. A follow-up biopsy two months after the diagnosis of AAIN in one patient revealed persistent cytopathic effects with negative adenoviral IHC staining while a biopsy at one year in another patient showed glomerular and tubulointerstitial scarring. AAIN is an uncommon but important etiology to consider in cases of acute renal allograft dysfunction. Although the presenting symptoms for AAIN are nonspecific, hematuria is frequently noted. Adenovirus IHC should be considered in cases with granulomatous inflammation associated with necrosis and mixed inflammatory infiltrate. As demonstrated in this single-institution case series, prompt diagnosis can result in the preservation of the renal allograft. Lasting cytopathic effects after adenoviral infection should also be considered in patients with a history, or potential history, of AAIN.

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Case Report: Early-Onset Adenovirus Nephritis Without Hemorrhagic Cystitis Following Kidney Transplantation

Attieh,

Roach,

Wadei

et al. 2024

Transplantation Proceedings

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The pathologic spectrum of adenovirus nephritis in the kidney allograft

Cited by 8 publications

References 57 publications

The effect of refined nursing education on improving the urination of patients after renal biopsy

The effect of refined nursing education on improving the urination of patients after renal biopsy

Adenovirus-Associated Acute Interstitial Nephritis With Graft Survival and Novel Follow-Up Biopsy Findings Including Karyomegaly: A Case Series

Case Report: Early-Onset Adenovirus Nephritis Without Hemorrhagic Cystitis Following Kidney Transplantation

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