The effect of Low-Dose Versus Standard-Dose Valganciclovir for Prevention of Cytomegalovirus Disease in Kidney Transplant Recipients. A Systematic Review and Meta-analysis

초록

Valgancivlovir is importantly used to prevent post-transplant CMV infection among kidney transplantation patients. However, the dose of such drug being used still remains controversial since the continuous use of such drug decreases kidney functions and induces leukopenia in some of the cases. Accordingly, the purpose is to measure the appropriate dose of the drug required for preventing CMV. Three trials were included, consisting of total of 523 patients In the pooled analysis. As a result of analyzing the two groups, the CMV incidence showed tendency to decrease in the low dose group. However, no statistical significant was indicated (P=0.109). Upon completion of the research, the GFR value, graft loss, tacrolimus level, fungal and candida infection indicated no difference between the two groups. However, the biopsy proven rejection decreased by 0.397 times in the low dose group in comparison to the standard group (P=0.002) and the leukopenia event decreased by 0.416 times in the low dose group in comparison to the standard group (P=0.001) as well. Conclusion : The dose of valganciclovir used to prevent the post-transplant CMV infection was adjusted to 450mg. As a result, such dose was effective in preventing CMV viremia and the side effects such as leukopenia caused by the drug also decreased.