Polyomavirus BK nephropathy: the effect of an early diagnosis on renal function or graft loss.
Polyomavirus BK nephropathy is a new complication among renal transplant patients. We studied 664 cadaver renal transplant recipients from February 1998 to February 2005, divided into two periods: 448 (group A, February 1998 to July 2003) and 176 (group B, August 2003 to February 2005). Twenty patients (3%) developed biopsy-confirmed polyomavirus BK nephropathy; 13 (2.9%) in group A after worsening renal function and 7 (3.9%) in group B after a prospective cytologic study in urine, examining for decoy cells, and a qualitative polymerase chain reaction (PCR) assay in urine and blood. The mean time to diagnosis was higher among group A (15.0 +/- 1.6 versus 7.2 +/- 4.0 months), as was the serum creatinine (2.5 +/- 0.7 versus 2.0 +/- 0.6 mg/dL). After 12 months the serum creatinine was 2.7 +/- 1.3 versus 1.7 +/- 0.2 mg/dL, respectively. Poor prognostic factors were a persistently positive PCR in blood and viral inclusions in the control biopsy.
Burgos
D
D
Nephrology Department, Hospital Universitario Carlos Haya, Malaga, Spain.
López
V
V
Cabello
M
M
Sola
E
E
Gutiérrez
C
C
García
I
I
Siles
J
J
Florez
P
P
González Molina
M
M
D000328:Adult; D000368:Aged; D001739:BK Virus / Q000302:isolation & purification; D001706:Biopsy; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000473:pathology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D027601:Polyomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology; D011183:Postoperative Complications / Q000821:virology*; D011379:Prognosis; D012189:Retrospective Studies; D017211:Treatment Failure; D014412:Tumor Virus Infections / Q000175:diagnosis* / Q000453:epidemiology
D003404:Creatinine