Risk factors for BK polyomavirus nephritis in renal allograft recipients

Paulo N. Rocha, Troy J. Plumb, Sara E. Miller, David N. Howell, Stephen R. Smith

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Recurrent episodes of acute rejection (AR) and/or the intense immunosuppression used for their treatment have been proposed as risk factors for BK nephritis (BKN; BK refers to the initials of the first patient from whom this polyomavirus was isolated). To further examine the relationship between AR and BKN, we analyzed all kidney transplants performed at our center between January 1999 and August 2001 (n = 286). After a mean follow-up of 737 ± 22 d, we identified nine cases of BKN (3.1 %). The mean time to diagnosis of BKN was 326 ± 56 d. No patient with BKN had a prior history of AR. During the same period, 62 patients were diagnosed with AR (22%). The mean time to diagnosis of AR was 197 ± 40 d (p = O.O1 vs. time to diagnosis of BKN). Despite aggressive therapy with methylprednisolone and, in some cases, anti-lymphocyte antibody, none of these patients with AR developed BKN. We compared the baseline characteristics of patients in both groups and found that BKN patients were more likely to be white people (78 vs. 44%, p = 0.05) and mate (89 vs. 53%, p = 0.04). Moreover, the mean tacrolimus (TAC levels before diagnosis were higher in BKN than in AR patients (11.7 ± 0.5 vs. 6.5 ± 0.6 ng/mL, p < 0.001). In summary, our study shows that BKN often occurs in the absence of prior episodes of AR. In addition, our findings suggest that white males exposed to higher TAC levels are at greater risk of developing BKN.

Original languageEnglish (US)
Pages (from-to)456-462
Number of pages7
JournalClinical Transplantation
Volume18
Issue number4
DOIs
StatePublished - Aug 1 2004

Fingerprint

BK Virus
Nephritis
Allografts
Kidney
Polyomavirus
Methylprednisolone
Tacrolimus
Immunosuppression
Anti-Idiotypic Antibodies
Lymphocytes
Transplants
Therapeutics

Keywords

  • Immunosuppression
  • Kidney transplantation
  • Kidney/pancreas transplantation
  • Polyomavirus
  • Rejection

ASJC Scopus subject areas

  • Transplantation

Cite this

Risk factors for BK polyomavirus nephritis in renal allograft recipients. / Rocha, Paulo N.; Plumb, Troy J.; Miller, Sara E.; Howell, David N.; Smith, Stephen R.

In: Clinical Transplantation, Vol. 18, No. 4, 01.08.2004, p. 456-462.

Research output: Contribution to journalArticle

Rocha, Paulo N. ; Plumb, Troy J. ; Miller, Sara E. ; Howell, David N. ; Smith, Stephen R. / Risk factors for BK polyomavirus nephritis in renal allograft recipients. In: Clinical Transplantation. 2004 ; Vol. 18, No. 4. pp. 456-462.
@article{defeb5c4210c4c499b987c33418059ca,
title = "Risk factors for BK polyomavirus nephritis in renal allograft recipients",
abstract = "Recurrent episodes of acute rejection (AR) and/or the intense immunosuppression used for their treatment have been proposed as risk factors for BK nephritis (BKN; BK refers to the initials of the first patient from whom this polyomavirus was isolated). To further examine the relationship between AR and BKN, we analyzed all kidney transplants performed at our center between January 1999 and August 2001 (n = 286). After a mean follow-up of 737 ± 22 d, we identified nine cases of BKN (3.1 {\%}). The mean time to diagnosis of BKN was 326 ± 56 d. No patient with BKN had a prior history of AR. During the same period, 62 patients were diagnosed with AR (22{\%}). The mean time to diagnosis of AR was 197 ± 40 d (p = O.O1 vs. time to diagnosis of BKN). Despite aggressive therapy with methylprednisolone and, in some cases, anti-lymphocyte antibody, none of these patients with AR developed BKN. We compared the baseline characteristics of patients in both groups and found that BKN patients were more likely to be white people (78 vs. 44{\%}, p = 0.05) and mate (89 vs. 53{\%}, p = 0.04). Moreover, the mean tacrolimus (TAC levels before diagnosis were higher in BKN than in AR patients (11.7 ± 0.5 vs. 6.5 ± 0.6 ng/mL, p < 0.001). In summary, our study shows that BKN often occurs in the absence of prior episodes of AR. In addition, our findings suggest that white males exposed to higher TAC levels are at greater risk of developing BKN.",
keywords = "Immunosuppression, Kidney transplantation, Kidney/pancreas transplantation, Polyomavirus, Rejection",
author = "Rocha, {Paulo N.} and Plumb, {Troy J.} and Miller, {Sara E.} and Howell, {David N.} and Smith, {Stephen R.}",
year = "2004",
month = "8",
day = "1",
doi = "10.1111/j.1399-0012.2004.00191.x",
language = "English (US)",
volume = "18",
pages = "456--462",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Risk factors for BK polyomavirus nephritis in renal allograft recipients

AU - Rocha, Paulo N.

AU - Plumb, Troy J.

AU - Miller, Sara E.

AU - Howell, David N.

AU - Smith, Stephen R.

PY - 2004/8/1

Y1 - 2004/8/1

N2 - Recurrent episodes of acute rejection (AR) and/or the intense immunosuppression used for their treatment have been proposed as risk factors for BK nephritis (BKN; BK refers to the initials of the first patient from whom this polyomavirus was isolated). To further examine the relationship between AR and BKN, we analyzed all kidney transplants performed at our center between January 1999 and August 2001 (n = 286). After a mean follow-up of 737 ± 22 d, we identified nine cases of BKN (3.1 %). The mean time to diagnosis of BKN was 326 ± 56 d. No patient with BKN had a prior history of AR. During the same period, 62 patients were diagnosed with AR (22%). The mean time to diagnosis of AR was 197 ± 40 d (p = O.O1 vs. time to diagnosis of BKN). Despite aggressive therapy with methylprednisolone and, in some cases, anti-lymphocyte antibody, none of these patients with AR developed BKN. We compared the baseline characteristics of patients in both groups and found that BKN patients were more likely to be white people (78 vs. 44%, p = 0.05) and mate (89 vs. 53%, p = 0.04). Moreover, the mean tacrolimus (TAC levels before diagnosis were higher in BKN than in AR patients (11.7 ± 0.5 vs. 6.5 ± 0.6 ng/mL, p < 0.001). In summary, our study shows that BKN often occurs in the absence of prior episodes of AR. In addition, our findings suggest that white males exposed to higher TAC levels are at greater risk of developing BKN.

AB - Recurrent episodes of acute rejection (AR) and/or the intense immunosuppression used for their treatment have been proposed as risk factors for BK nephritis (BKN; BK refers to the initials of the first patient from whom this polyomavirus was isolated). To further examine the relationship between AR and BKN, we analyzed all kidney transplants performed at our center between January 1999 and August 2001 (n = 286). After a mean follow-up of 737 ± 22 d, we identified nine cases of BKN (3.1 %). The mean time to diagnosis of BKN was 326 ± 56 d. No patient with BKN had a prior history of AR. During the same period, 62 patients were diagnosed with AR (22%). The mean time to diagnosis of AR was 197 ± 40 d (p = O.O1 vs. time to diagnosis of BKN). Despite aggressive therapy with methylprednisolone and, in some cases, anti-lymphocyte antibody, none of these patients with AR developed BKN. We compared the baseline characteristics of patients in both groups and found that BKN patients were more likely to be white people (78 vs. 44%, p = 0.05) and mate (89 vs. 53%, p = 0.04). Moreover, the mean tacrolimus (TAC levels before diagnosis were higher in BKN than in AR patients (11.7 ± 0.5 vs. 6.5 ± 0.6 ng/mL, p < 0.001). In summary, our study shows that BKN often occurs in the absence of prior episodes of AR. In addition, our findings suggest that white males exposed to higher TAC levels are at greater risk of developing BKN.

KW - Immunosuppression

KW - Kidney transplantation

KW - Kidney/pancreas transplantation

KW - Polyomavirus

KW - Rejection

UR - http://www.scopus.com/inward/record.url?scp=4043121785&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4043121785&partnerID=8YFLogxK

U2 - 10.1111/j.1399-0012.2004.00191.x

DO - 10.1111/j.1399-0012.2004.00191.x

M3 - Article

C2 - 15233826

AN - SCOPUS:4043121785

VL - 18

SP - 456

EP - 462

JO - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 4

ER -