title: Risk Factors for the Development of BK Virus Nephropathy in Renal Transplant Recipients.
abstract: The BK polyoma virus has, in recent years, become a significant cause of renal allograft dysfunction and failure. Among 260 adult kidney transplant recipients, those with biopsy-proven BK virus nephropathy (BKVN) were compared with those without BKVN with regard to gender, age, race, rejection episodes, time on dialysis, number of organs transplanted, HLA match, live donor versus deceased donor, cold ischemia time, delayed graft function, cytomegalovirus (CMV) serostatus of donor and recipient, induction therapy, and maintenance immunosuppression. Episodes of rejection (35.7% of patients with BKVN vs 8.5% of patients without BKVN; P = .01), transplantation of >1 organ (35.7% of patients with BKVN vs 9.0% of patients without BKVN; P = .01), positive CMV serology in both donor and recipient (71.4% of patients with BKVN vs 41.1% of patients without BKVN; P = .03), and a greater cumulative dose of daclizumab use at the time of induction (2.24 ± 0.05 mg/kg in patients with BKVN vs 2.03 ± 0.14 mg/kg in patients without BKVN; P = .04) were statistically significant risk factors for the development of BKVN. Those who developed BKVN received a higher mean cumulative dose of rabbit antithymoglobulin for induction therapy, but that difference failed to achieve statistical significance (P = .07).
authors.affiliation: Department of Medicine, Division of Nephrology at Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: D
authors.initials: D
authors.lastname: Pai
authors.affiliation: Temple University School of Medicine, Philadelphia, Pennsylvania; Department of Neurosurgery, University of Colorado School of Medicine, Denver, Colorado.
authors.forename: D M
authors.initials: DM
authors.lastname: Mann
authors.affiliation: Department of Medicine, Division of Nephrology at Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: A
authors.initials: A
authors.lastname: Malik
authors.affiliation: Department of Statistics at Rutgers University, New Brunswick, New Jersey.
authors.forename: D R
authors.initials: DR
authors.lastname: Hoover
authors.affiliation: Department of Pathology at Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: B
authors.initials: B
authors.lastname: Fyfe
authors.affiliation: Department of Medicine, Division of Nephrology at Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey. Electronic address: mannri@rutgers.edu.
authors.forename: R A
authors.initials: RA
authors.lastname: Mann
mesh_terms: D000328:Adult; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D001739:BK Virus; D001706:Biopsy; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007674:Kidney Diseases / Q000821:virology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000209:etiology*; D012307:Risk Factors; D066027:Transplant Recipients; D014184:Transplantation, Homologous / Q000009:adverse effects; D014412:Tumor Virus Infections / Q000209:etiology*
chemical_list: D000961:Antilymphocyte Serum