Chlamydia pneumoniae infection has been postulated to have a role in the development of arteriosclerosis. The earlier studies from this center showed that the incidence of Chlamydia infection in end stage renal failure patients is much higher than in normal population. Recently we examined 86 renal alograft recipients, 5 – 10 years after transplantation. In 39 patients the renal function was impaired (Scr>2 mg/dL), and remaining 47 had stable renal function (Scr <2 mg.dL). Kidney biopsies showed presence of vascular changes in29/86 patients and changes typical for chronic alograft nephropathy (interstitial fibrosis and tubular atrophy) in 28/86 recipients). All patients were examined for the presence of C. pneumoniae DNA in peripheral blood leucocytes (real time PCR) and the presence of IgG and IgA antibodies in the serum.
Twenty four out of 86 patients were C. Pneumoniae PCR positive. A comparison of the patients with histologically diagnosed chronic renal nephropathy and patients without nephropathy revealed statically significant difference as to the presence of C pneumoniae DNA in peripheral blood leucocytes (38.5% vs 19.1%; p=0.04). Vascular changes in kidney biopsies were present in 13/24 (54%) C.pneumoniae PCR + patients in comparison to only 25,8% of non- infected patients (p=0.02). At 24 months additional follow-up graft survival differed significantly between C. pneumoniae infected and non-infected patients (29% vs 8%; p=0.04) as did the percentage of patients with serum creatinine concentration below 2 mg% (84.5% vs 62.5%; p=0.03)
The analysis of factors which could have influenced graft function and survival showed the effect of the method of kidney storage, number of acute rejection episodes, serum triglycerides concentration, and Chlamydia pneumoniae infection.
Infection with Chlamydia pneumoniae seem to be an additional risk factor of chronic graft nephropathy.