INFECÇÕES FÚNGICAS EM TRANSPLANTADOS RENAIS: UMA REVISÃO INTEGRATIVA / FUNGAL INFECTION IN RENAL TRANSPLANTATION: A INTEGRATIVE REVIEW

Introducao: A doenca renal cronica em estagio avancado apresenta a dialise e o transplante como formas de tratamento substitutivo. O transplante renal e uma das principais formas de tratamento da medicina moderna, promovendo qualidade de vida e aumento da sobrevida dos pacientes. Esses, ao longo de sua vida pos-transplante, necessitam fazer uso de agentes imunossupressores. Assim, o paciente transplantado apresenta risco aumentado para infeccoes oportunistas, dentre as quais se encontram as infeccoes por fungos. Objetivo: Verificar a literatura existente acerca das infeccoes fungicas que acometem pacientes transplantados renais. Metodo: Estudo do tipo revisao integrativa da literatura, cujo levantamento ocorreu nas bases de dados PubMed, LILACS, MEDLINE e SciELO, utilizando-se os descritores infeccoes fungicas invasivas, micoses e transplante renal. Foram selecionados artigos originais publicados entre 2006 e 2016, em ingles, espanhol ou portugues, disponibilizados na integra e que abordassem infeccoes fungicas em pacientes transplantados renais. Resultados: Conforme criterios estabelecidos, foram encontrados quatorze artigos, dos quais dez eram relatos de caso e quatro eram estudos do tipo coorte. Observouse que os principais fungos citados foram dos generos Aspergillus, Rhizopus, Candida e Scedosporium, o principal sitio de infeccao foi o pulmao e os principais medicamentos utilizados no tratamento foram o Voriconazol e a Anfotericina B. Conclusao: Por meio desta revisao verificou-se carencia de estudos na literatura nacional, sendo internacional a totalidade dos artigos encontrados. Torna-se relevante, portanto, maior investimento em pesquisas e divulgacao dos resultados, a fim de ampliar o conhecimento acerca dessas infeccoes no pais. Palavras-chave: Infeccoes Oportunistas. Infeccoes Fungicas. Transplante Renal. Abstract Introduction: Advanced chronic kidney disease presents dialysis and transplantation as forms of substitutive treatment. Renal transplantation is one of the main ways of treating modern medicine, promoting quality of life and increasing patient survival. These, throughout their post-transplant life, need to make use of immunosuppressive agents. Thus, the transplanted patient presents an increased risk for opportunistic infections, among which are fungal infections. Objective: To verify the existing literature on the fungal infections that affect renal transplant patients. Method: An integrative review of the literature was carried out in the PubMed, LILACS, MEDLINE and SciELO databases, using the descriptors invasive fungal infections, mycoses and renal transplantation. We selected original articles published between 2006 and 2016, in English, Spanish or Portuguese, available in full and that deal with fungal infections in renal transplant patients. Results: According to established criteria, fourteen articles were found, of which ten were case reports and four were cohort studies. It was observed that the main fungi mentioned were of the genus Aspergillus, Rhizopus, Candida and Scedosporium, the main site of infection was the lung and the main drugs used in the treatment were Voriconazole and Amphotericin B. Conclusion: Through this review, it was verified there was a lack of studies in the national literature, being international the totality of the articles found. Therefore, greater investment in research and dissemination of results is relevant, in order to increase knowledge about these infections in the country. Keywords: Opportunistic Infections. Mycoses. Kidney Transplantation.