title: [Analysis on BK virus associated nephropathy related risk factors in renal transplant recipients].
abstract: OBJECTIVE
  To analyze the risk factors affecting BK virus associated nephropathy (BKVAN) after kidney transplantation.
  
  
  METHODS
  Three screening methods for BKVAN including quantitative PCR assay for BK virus (BKV) DNA load in urine and plasma and quantitative assay of urine cytology concurrently with renal transplant biopsies for the evaluation of 615 patients from January 2006 to December 2014 were used. The renal allograft biopsy specimens were analyzed by routine histologic examination, immunohistochemistry and classified into three categories of BKVAN. Potential variables were analyzed by Logistic regression model multivariate analysis to assess and rank BKVAN related risk factors.
  
  
  RESULTS
  The positive rate of urine decoy cell , BKV viruria and viremia in 615 renal recipients were 13.7% (84/615), 29.3% (180/615), and 8.8% (54/615), respectively. BKVAN were diagnosed in 49 recipients. The incidence and the median level of the number of the decoy cell, BK viral load in urine and plasma were higher in the BKVAN group than those in non-BKVAN group (all P<0.05). Tacrolimus (Tac) combined with mycophenolic acid (MPA) protocol (OR=12.4, P=0.001) and severe pneumonia post-transplant (OR=3.7, P=0.001) were the independent risk factors impacting on BKVAN in renal recipients.
  
  
  CONCLUSIONS
  The renal recipients with high level of BKV replication, whose immunosuppressant protocol include Tac and MPA, should be suspected the diagnosis of BKVAN.
authors.affiliation: Department of Organ Transplantation, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Huang
authors.forename: Changxi
authors.initials: C
authors.lastname: Wang
authors.forename: Xiaojing
authors.initials: X
authors.lastname: Luo
authors.forename: Yanchun
authors.initials: Y
authors.lastname: Huang
authors.forename: Jiguang
authors.initials: J
authors.lastname: Fei
authors.forename: Suxiong
authors.initials: S
authors.lastname: Deng
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Guodong
authors.initials: G
authors.lastname: Chen
authors.forename: Qian
authors.initials: Q
authors.lastname: Fu
authors.forename: Ronghai
authors.initials: R
authors.lastname: Deng
authors.affiliation: Email: guhuil@mail.sysu.edu.cn.
authors.forename: Jiang
authors.initials: J
authors.lastname: Qiu
authors.forename: Lizhong
authors.initials: L
authors.lastname: Chen
mesh_terms: D001739:BK Virus; D001706:Biopsy; D004279:DNA, Viral; D006801:Humans; D007166:Immunosuppressive Agents; D007668:Kidney; D007674:Kidney Diseases; D016030:Kidney Transplantation; D009173:Mycophenolic Acid; D027601:Polyomavirus Infections; D060888:Real-Time Polymerase Chain Reaction; D012307:Risk Factors; D016559:Tacrolimus; D066027:Transplant Recipients; D014184:Transplantation, Homologous; D019562:Viral Load; D014766:Viremia
chemical_list: D004279:DNA, Viral; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D016559:Tacrolimus