Monitoring of Serum Neopterin Levels in Renal Transplant Recipients: Increased Values during Impaired Renal Function and Cytomegalovirus Infection

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Abstract
In 92 renal transplant recipients, serum or plasma levels of neopterin were significantly elevated during pretransplant uremia, rejection, ciclosporin A induced nephrotoxicity and cytomegalovirus (CMV) infections. In patients with normal serum creatinine ( < 115 μmol/l) 71% had elevated serum neopterin levels. None of 19 ciclosporin A treated patients with stable renal function had a normal level of neopterin compared to 50% for patients treated with azathioprine (p < 0.05). Due to the dependency on renal function the serum levels of neopterin could not distinguish between rejection and ciclosporin A induced nephrotoxicity. Marked increases in neopterin levels were seen during infections and especially during CMV infection. Determination of neopterin levels may be helpful in the diagnosis of CMV infection.