title: Biopsy-Proven BK Virus-Associated Nephropathy: Clinico-Pathologic Correlations.
abstract: OBJECTIVE
  Our objective was to study the clinico-pathologic correlations in BK virus nephropathy.
  
  
  METHODS
  We conducted a retrospective study of all patients with biopsy-proven polyoma (BK) virus infection. We compared their survival and renal outcomes versus BK virus-negative patients with biopsy-proven graft rejection. Histopathologic characterization by a blinded nephropathologist was performed.
  
  
  RESULTS
  BK nephropathy was found in 10 patients biopsied for graft dysfunction. All virus-positive patients received antithymocyte globulin induction therapy compared with only 59.3% of the BK-negative group (P = .06). The percentage of patients in the BK-negative group who received acyclovir was significantly higher than that in the BK-positive group (P = .01). After a mean observation period of 6.8 ± 3.2 years, 70% of the BK group had functioning grafts compared with 68% in the BK-negative group (P = .9) with similar 3-year graft survival in the 2 groups (80% and 90%; P = .8). Within the BK group, graft survival was better in the older group (P = .005) and in those with deceased donor kidney grafts (P = .016). Patients in the BK-negative group were heavier (mean weight of 64.3 ± 12.1 vs 46.7 ± 20.6 kg; P = .003). None of the histopathologic features studied had any effect on renal prognosis.
  
  
  CONCLUSIONS
  The risk factors for developing BK nephropathy were use of antithymocyte globulin, lower weight, and not using acyclovir as early prophylaxis. Within the BK nephropathy group, better graft survival was observed in deceased donor kidney recipients and in older patients. The viral load and polyoma virus nephropathy stage did not affect graft survival in this small sample study.
authors.affiliation: From the King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Jahdali
authors.forename: Noura
authors.initials: N
authors.lastname: Al Oudah
authors.forename: Khaled O
authors.initials: KO
authors.lastname: Alsaad
authors.forename: Hala
authors.initials: H
authors.lastname: Kfoury
authors.forename: Salem
authors.initials: S
authors.lastname: Qurashi
authors.forename: Abdulla
authors.initials: A
authors.lastname: Al Sayyari
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000961:Antilymphocyte Serum / Q000009:adverse effects; D000998:Antiviral Agents / Q000627:therapeutic use; D001739:BK Virus / Q000187:drug effects / Q000302:isolation & purification*; D001706:Biopsy; D001835:Body Weight; D002648:Child; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000187:drug effects / Q000473:pathology* / Q000821:virology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control / Q000821:virology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D014412:Tumor Virus Infections / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control / Q000821:virology; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D000212:Acyclovir