title: Polyomavirus nephropathy in kidney transplantation.
abstract: Polyomavirus nephropathy has become an important complication in kidney transplantation, with a prevalence of 1% to 8%. Unfortunately, the risk factors for polyomavirus nephropathy and renal allograft loss are not well defined. The definitive diagnosis is made through assessment of a kidney transplant biopsy. Recently, noninvasive urine and serum markers have been used to assist in polyomavirus nephropathy diagnosis and monitoring. Primary treatment is immunosuppression reduction, but must be balanced with the risks of rejection. No antiviral treatments for polyomavirus nephropathy have been approved by the Food and Drug Administration. Although cidofovir has shown in vitro activity against murine polyomaviruses, and has been effective in some patients, it is associated with significant nephrotoxicity. Graft loss due to polyomavirus nephropathy should not be a contraindication to retransplantation; however, experience is limited. This review presents potential risk factors, screening, diagnostic and monitoring methods, therapeutic management, and retransplantation experience for polyomavirus nephropathy.
authors.affiliation: University of Cincinnati, Division of Transplantation, Ohio, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Trofe
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gordon
authors.forename: Prabir
authors.initials: P
authors.lastname: Roy-Chaudhury
authors.forename: Igor J
authors.initials: IJ
authors.lastname: Koralnik
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Atwood
authors.forename: Rita R
authors.initials: RR
authors.lastname: Alloway
authors.forename: Kamel
authors.initials: K
authors.lastname: Khalili
authors.forename: E Steve
authors.initials: ES
authors.lastname: Woodle
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D001706:Biopsy; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000379:methods; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects*; D008403:Mass Screening; D011120:Polyomavirus / Q000145:classification / Q000472:pathogenicity / Q000502:physiology; D027601:Polyomavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D012086:Reoperation; D012307:Risk Factors
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents